UC-NRLF 


Ifi 


MEDICAL 


IK  i/iSMOE 
A.K.    CRAWFORD,    M.D. 


T  II  1C 


ANATOMIST. 


ED  UPO.\-  "GKAl'.") 

BY  C.  HENRI  LEONARD,  A,  M.,  M,  D. 

' 


SECOND  ENLARGED  EDITION. 
VIIlTH  THOUSAND. 


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neck,  10  are  given;  (Illustrated.)  Chapter  VII.- Ban- 
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ty, 56  are  given;  (Illustrated.)  Chapter  X. — Immovable 
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CONTENTS.— Medium  and  maximum  DOSES  of  all  officinal 
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ting. A  complete  list  of  INCOMPATIBLES.  Ditto  of  POISONS 
and  their  ANTIDOTES,  and  Tests  for  same.  Rules  for  resusci- 
tation of  the  drowned,  tr-  atment  of  poisoned  wounds,  etc.  A 
complete  table  ot  tests  for  URINARY  DEPOSITS.  OBSTE- 
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and  accidents.  PRONUNCIATION  of  Medico-Biographical 
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Measurements  for  guides  in  auscultation  and  percussion. 
Table  of  the  Exanthemata,  and  differential  diagnosis.  Tables 
Of  WEIGHTS,  MEASURES,  etc.,  both  French  and  American. 
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laneous matter,  useful  in  emergencies. 

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NECK. 

MUSCLES. 

(Nervous  supply  is  indicated  by  [    ]  brackets.) 
The  —  dash  divides  the  origin  from  the  insertion. 

(l)   EPICRANIAL  REGION   I. 

GCCip'itC-fronta'lis  ;  outer  %  superior  curved  line  of  Occiput, 
and  mastoid  process — frontal  quadrilateral  expansion  to  the 
facial  muscles.  [Supra-orbital,  facial,  occipital,  posterior 
auricular. 

(2)  AURICULAR   REGION   3. 

AUollens  au'rem ;  occipital  fascia— upper  part  of  pinna, 
[Small  occipital.  ] 

Al/knhC-S  a'i'ma  :  lateral  edge  aponeuro'sis  of  occipito- 
frontalis — front  of  helix.  [Facial,  inferior  maxillary.] 

Ket'rahens  au'rem :  mastoid  process — lower  cranial  surface  of 
the  concha.  [Facial.] 

(3)  INTRA-ADRICULAR   REGION  4. 

Ten'SOP  tym'pani  Z  inferior  surface  petrous  bone,  Eustachian 
tube — backwards  to  handle  malleus.  [Otic  ganglion.] 

Lasa'tor  tyia'pani  na'jor:  spinous  process  sp'i  enoid, Eustachian 
tube— back  through  Glaserian  fissure  to  neck  of  the  malleus, 
[Facial.] 

Laxa'tor  tym'pani  mi'nor  I  superior  and  posterior  part  external 
meatus—  for-and  inwards  to  handle  of  the  malleus.  [Facial.] 

Staps'dius:  interior  of  pyramid — forward  to  neck  of  stapes, 
[Facial.] 

(4)   PALPEBRAL    REGION  (4)  3. 

CrttCUla'riS  palpabra'nim :  internal  angular  process  frontal 
"bone,  na.-al  process  superior  maxilla,sphincter  of  eye.  [Facial 
and  supra-orbital.] 

Comga'tOP  SUperciTii :  inner  extremity  superciliary  ridge- 
under  surface  orbi  nl  ris,  opposite  the  middle  of  the  orbital 
arch.  [Facial,  supra-orbital.] 

Ton'nor  tar'si:  crest  of  os  lachrymalis-  tarsal  cartilage 
nearpuncta;  covers  in  lachrymal  canals.  [Facial.] 

(5)   ORBITAL  REGION  7. 

Lava'tOP  palps'traj  SUpsrio'rlS  :  inferior  surface  lesser  wing  of 
spheiu-i  1,  anteriorly  to  foramen  opticum — upper  border  su- 
perior tarsal  cartilage.  [Hid.] 

Eec'tlS  Svips'ricr:  margin  optic  foramen — sclerotica.     [Hid.] 
Roc'tus  infs'rior  :  optic  foramen — sclerotica.     [Hid.] 
SflC'tuB  intsr'nus  :  optic  foramen— sclerotica.    [Hid.] 


HEAD  AND  NECK. 


S:  2  heads  between  which  pass  Hid.,  nasal 
branch  of  Vth,  and  Vlth  nerves  and  opthalmic  vein;  ufj>er 
from  outer  margin  optic  foramen,  lower  from  ligament  of  Zinn 
and  process  of  bone  at  sphenoidal  fissure  —  sclerotica.  [Vlth.] 

Oblio/UUS  Bupe'rior  :  near  optic  foramen  —  "  pulley"  thence  at 
right  angle  to  sclerotica.  [I  Vth.] 

OWiO/UUS  isfe'rior:  depression  in  orbital  plate  in  superior 
maxilla—  sclerotica,  outer  surface.  [  Hid.] 

(6)   NASAL   REGION   7. 

PyramidaliS  na'si  :  occipito-frontalis—  compressor  naris.  [Fa- 
cial.] 

Leva'tor  laTm  superio'ris  aln'qtie  na'si  :  nasal  process  superior 

maxilla  —  cartilage  of  the  ala  and  lip.     [Facial.] 

Dill'tor  na'ris  ante'rior:  Cartilage  ala—  inner  border  integument 
ala.  [Facial.] 

Dila'tor  na'ris  poste'rior:  nasal  notch  superior  maxilla  —  skin  at 
inner  margin  nostril.  [Facial.] 

Compres'sor  na'ris  :  above  incisive  fossa  superior  maxilla  — 
pyramidalis  nasi,  nasal  fibro-cartilage,its  fellow  opposite  side. 
[Facial.] 

Compressor  na'rium  mi'nor  S  alar  cartilage  —  skin  at  the  end  of 
the  nose.  [Facial.] 

Depres'sor  ala  na'si  :  incisive  fossa  superior  maxilla  —  septum 
and  ala  nasi.  [Facial.] 

(7)  SUPERIOR  MAXILLARY    REGION  4. 

Leva'tOT  laljii  snpario'ris  :  lower  margin  orbit—  lip.     [Facial.  ] 
Leva'tor  an'gnli  O'ris  :  canine  fossa   superior   maxilla  —  angle 

mouth.     [Facial.] 

SygOmat'icuS  ma'jor  :  in  front  zygoma—  angle  oris.     [Facial.] 
Eygonat'icuS'mi'nor  :  malar  bone  near  maxillary  suture  —  angle 

oris.    [Facial.] 

(8)  INFERIOR  MAXILLARY   REGION  3. 

Leva'tor  latii  Inferio'ris,  or  Leva'tor  msn'ti:  incisive  fossa  infe- 

rior maxilla—  skin  of  chin.     [Facial.] 

Eepres'SOr  la'bii  hforo'ris  :  external  oblique  line  inferior  maxilla 
—  integument  of  lower  lip.  [Facial.] 

Bepres'sor  an'guli  o'ris,  or  Quadra'tus  men'ti  \  external  oblique  line 
inferior  maxilla  —  angle  oris.  [Facial.] 

(9)   INTER-MAXILLARY    REGION   3. 

Qrbicula'riS  o'ris  :  sphincter  oris.     [Facial.] 

Buccina'tor  :  alveolar  processes  superior  and  inferior  maxillae  — 
converges,  to  the  angle  of  the  mouth,  and  orbicularis.  [Facial, 
inferior  maxillary.] 

s:  fascia  above  masseter—  angle  oris.    [Facial.] 


(lo)  TEMPORO-MAXILLARY  REGION  2. 

!  malar  process  superior  maxilla,  lower  border 
»ygoma— angle  and  lower  half  ramus  inferior  maxilla,  outer 
varface.  [Inferior  maxillary.] 

Tempora'liS  I  temporal  fossa,  curved  line  of  frontal  and  par- 
ietal bones,  pterygoid  ridge  of  sphenoid — coronoid  process 
inferior  maxilla.  [Inferior  maxillary.] 

fll)   PTERYGO-MAXILLARY  REGION  2. 

PterygOido'uS  inter'aus:  pterygoid  fossa,  tuberosity  palate 
bone— lewer  and  inner  side  ramus  inferior  maxilla.  [Inferior 
snaxillary.] 

Pterygoide'us  ozter'nus :  -upper  head  from  pterygoid  ridgvi 
great  wing  of  sphenoid  ;  tower  from  external  pterygoid  plate, 
tuberosity  of  palate,  and  superior  maxillary  bones— pterygoid 
depression  in  front  condyle  inferior  maxilla.  [Inferior  maxil- 
lary.] 

(l)  SUPERFICIAL  CERVICAL   REGION  2. 

Platys'ma myoido'US  :  clavicle,  acromian  process,  fascia  of  del- 
toid and  pectoralis  major — inferior  maxilla  below  external  ob- 
lique line.  [Facial,  superior  cervical.] 

Ster'nO-Clei'do-mastoido'nS  S  sternum  and  clavicle — mastoid  pro- 
cess, superior  occipital  curved  line.  [Spinal  accessory,  cervi- 
cal plexus.] 

(2)   INFRA-HYOID    REGION  4. 

Stor'nO-hyoids'llS":  sternum  and  sternal  end  of  clavicle — hyoid 
bone.  [Communicating  branch  of  descendens  and  commu- 
nicans  noni.] 

Ster'nO-thyroide'uS  :  upper  posterior  edge  sternum— oblique 
line  of  ala  of  cartilage  (thyroid.)  [Communicating  branch  of 
descendens  and  communicans  noni.] 

Thy'ro-hyoidfl'us :  Oblique  line  of  thyroid  cartilage— body 
and  greater  cornu  hyoid  bone.  [Hypoglossal.] 

O'mO-hyoid&'llS :  upper  border  scapula  (bound  down  to  clav- 
icle by  cervical  fascia)— hyoid  bone.  [Communicating  branch 
of  descendens  and  communicans  noni.] 

(3)  SUPRA-HYOID  REGION  4. 

Eigas'triCUS:  mastoid  process  of  temporal  (ligament  binding 
to  hyoid  bone) — symphysis  inferior  maxilla.  [Facial,  inferior 
dental.] 

Sty'lO-hyoide'US  I  outer  surface,  middle  styloid  process — 
body  hyoid  bone,  perforated  by  digastricus.  [Facial.] 

Mylo-hyoide'uS :  (forms  floor  of  mouth)  mylo-hyoid  ridge  of 
inferior  maxilla— body  of  os  hyoides.  [Inferior  dental.] 


4  HEAD  AND   NECK. 

OrO'nio-liycids'llS ;  inferior  genial  tubercle  inferior  maxilla — 
body  os  hyoides.  [Hypoglossal.] 

(4)    LINGUAL   REGION   (5)   4. 

Ofa'n:0-hy:-glos'£US  :  superior  genial  tubercle  of  inferior  maxil- 
la— os  hyoides  and  whole  length  inferior  surface  tongue. 
[Hypoglosal.] 

n,"-glos'SU3 *.  side  of  body  and  greater  and  lesser  cornua 
hyoid  — back  and  side  of  tongue.  [Hypogloss:.!.] 

LlUgua'.iS ;  under  surface  glossa  from  b.;so  to  tip,  between 
hyo-g'ossus  and  Gcnio-hyo-glossus.  [Chorda  tympani.] 

St:'lo-glo/SU::  outer  and  anterior  center  styloid  process — 
side  of  tongue.  [Hypoglossal.] 

(5)   PHARYNGEAL   REGION   (5)  4. 

Constric'tor  infe'riorl  sides  of  cricoid  and  thyroid  cartilages 
— fibrous  raphe  of  posterior  median  line  of  pharynx.  [Pharyn- 
geal plexus,  glosso-pharyngeal,  external  laryngeal.] 

Coistric'tor  me'diu::  greater  and  lesser  cornua  hyoid— poste- 
rior median  pharyngeal  raphe.  [Glosso-pharyngeal,  pharyn- 
geal plexus.] 

Con.tric'tor  Superior  :  lower  3d  of  the  margin  of  internal  ptery- 
goid  plate,  palate  and  contiguous  palatal  muscles — posterior 
median  pharyngeal  raphe  and  occipital  pharyngeal  spine. 
[Glosso-pharyngeal,  pharyngeal  plexus.] 

Sty'lo-pha"7Cge'::3 :  inner  side  base  of  styloid  process— con- 
strictor muscles  and  upper  border  thyroid  cartilage.  [Glosso- 
pharyngeal  and  pharyngeal  plexus.] 

(6)   PALATAL  REGION   5. 

Leva'for  pala'ti:  under  surface  petrous  portion  of  temporal, 
Eustachian  tube — posterior  surface  soft  palate.  [Facial.] 

Ten':;r  pala'ti:  scaphoid  fossa  of  the  sphenoid,  Eustachian 
tube  (bound  to  hamular  process) — anterior  surface  hard  and 
soft  palate.  [Otic  ganglion.] 

Az'ygOS  EV'uls  :  posterior  n?sal  spine  palate  bone— uvula. 
[Facial.]  (Is  not  a  single  muscle  as  its  name  implies.) 

Pl'a'tC-glOS'SUS :  (anterior  pillar)  anterior  lateral  surface  soft 
palate — side  and  dorsum  of  tongue.  [Meckel's  gan^licn.] 

Pala'tO-phr.ry: gO'-3  -  (posterior  pillar)  soft  palate — jolr.s  stylo- 
pharyngeus  to  be  inserted  into  posterior  border  thyroid  carti- 
lage. [Meckel's  ganglion.] 

(7)  IXTRA-LARYNGEAL  REGION  5. 

GrrcC-thyTOide'rs:  front  and  side  of  ciicoid — up-  and  outwards 
to  lower  border  thyroid  cartilage.  [Laryngeal  to  the  muscles 
this  group.] 

Thy'- O-arjtseaoide'uS :  posterior  surface  thyroid  cartilages  and 


MUSCLES.  5 

crico-thyroid  membrane— backwards  to  anterior  surface  ary- 
tenoid cartilage  ;  (false  vocal  cord.) 

Cri'CO-a:ytxnolde'U3  latera'lij:  superior  border  cricoir!  carti- 
lage— obliquely  up-  and  backwards  to  external  angle  Dase  ary- 
tenoid cartilage. 

Cri'O-ry  Knoids'uS  posts'. ior:  posterior  surface  cricoid  carti- 
lage—  up-  and  outwards  to  external  angle  base  arytenoid. 

Arytsnoide'uS  :  fills  up  posterior  concave  surface  of  arytenoid 
cartilage. 

(8)   EPIGLOTTIDIAN   REGION  3. 

Thy'rO-epig'ot  ido'us  :  internal  surface  thyroid  cartilage — up- 
wards to  margin  of  epiglottis.  [Laryngeal  to  the  muscles  of 
this  group.] 

Ary.K'nO-epigiOttide'US  SUps'rior  I  apex  arytenoid  cartilage — to 
fold  mucous  membrane  between  arytenoid  cartilage  and  side 
of  epiglottis. 

JLryt;2'nO-epig'ottide'uS  infe'lior  :  arytenoid  cartilage  just  above 
superior  vocal  cord — forwards  and  upwards  to  the  margin  of 
the  epiglottis. 

(9)  ANTERIOR  VERTEBRAL  REGION  4. 

Bec'tus  Cap'itiS  anti'cus  ma'jor  :  (continuation  scalenus  anticus) 
4  slips  from  anterior  tubercles  transverse  processes  3d,  <th, 
5th  and  6th  cervical  vertebrae— 'basilar  process  occipital  bone. 
[Suboccipital  and  cervical  plexus.] 

RfiC'tuS  Cap'itiS  ant/CUSmi'ncr  :  anterior  surface  lateral  mass  of 
atlas  and  its  transverse  process — basilar  process  occipital. 
[Suboccipital,  cervical  plexus.] 

Bec'tus  latora'lis:  upper  surface  transverse  process  atlas- 
jugular  process  occipital.  [Suboccipital.] 

Lon'rus  COl'li !  ist  portion  from  anterior  tubercles  transverse 
processes  of  sd,  4th  and  5th  cervical  vertebrae-tubercle  of  an- 
terior arch  of  atlas;  zd  portion  from  ist,  2d  (and  3d)  dorsal — 
transverse  processes  5th  and  6th  cervical  vertebrae  ;  -^d  portion 
from  ist,  ad,  3d  dorsal  and  jth,  6th,  5th  cervical— bodies  zd, 
3d  and  4th  cervical  vertebrae.  [Lower  cervical  branches.] 

(10)  LATERAL  VERTEBRAL  REGION.    3. 

Scale'nUS  anti'CUS:  inner  border  and  superior  surface  ist  rib 
— anterior  tubercles  transverse  processes  3d,  4th,  5th  and  6th 
Cervical  vertebrae.  [Branches  lower  cervical.] 

Scale'nufine'dius  \  behind  groove  for  subclavian  artery  on  ist 
rib — posterior  tubercles  transverse  processes  lower  6  cervical 
vertebrae.  [Branches  lower  cervical.] 

Scils'nUS  po:ti'CUB !  2d  rib,  outer  surface — transverse  proces- 
ses lower  3  cervical  vertebrae.  [Branches  lower  cervical.] 


6  HEAD  AND  NECK. 

(ll)    POSTERIOR   VERTEBRAL   REGION  4. 

Sec'tUS  Cap'itiS  pOSti'CUS  ma'jor :  spinous  process  axis — inferior 
occipits.1  curved  line.  [Occipital.] 

Eoc'tus  Cap'itiS  JOSti'CUSmi'aor:  tubercle  posterior  arch  atlas— 
beneath  insertion  of  above.  [Occipital.] 

Owli^'uUS  Infe'rior:  spinous  process  axis  —  horizontally  to 
transverse  process  atlas.  [Occipital.] 

Obliil'uus  Supe'ri:r  :  transverse  process  atlas— occipital  bone, 
between  curved  lines.  [Occipital.] 



ARTERIES. 

CABOT1S  COMMUinS;  arises  on  right  side,  from  innominate, 
behind  sterno-clavicular  articulation  ;  on  left  side,  from  arch 
of  aorta,  highest  part,  and  is  more  deeply  placed  than  th« 
right  and  passes  obliquely  outwards  to  root  of  neck  behind 
sterno-hyoid  and  sterno-thyroid  muscles,  innominate  vein 
and  thymus  gland.  Starting  now  from  each  side  of  neck 
each  pass  up—  and  outwards  to  superior  border  of  thyroid 
cartilage,  there  dividing  into  external  and  internal  carotid. 
Course  indicated  by  line  from  sternal  end  clavicle  to  point 
midway  between  mastoid  process  and  angle  of  inferior  maxilla. 
Vein  lies  to  outside,  pneumogastric  nerve  on  posterior  plane 
between  them,  the  three  being  enveloped  by  same  sheath  of 
cervical  fascia.  No  branches  but  terminal. 

CASO'TIS  EZTEB'ITA:  (8  brs.,  see  above)  up  between  neck  of 
inferior  maxilla  and  external  meatus,  there  dividing  into  tem- 
poral and  internal  maxillary.  Crossed  by  hypoglossal  nerve, 
lingual  and  facial  veins,  digastric  and  stylo-hyoid  muscles. 
Is  quite  superficial.  Thyroide'a  Supe'rior  I  greater  cornu  hyoid, 
curving  down  to  thyroid  gland  anas,  with  its  fellow  of  oppo- 
site side  and  inferior  thyroid.  Hyoide'a,  runs  along  inferior 
border  of  bone,  anas,  with  opposite  fellow.  Descen'dens  su- 
ferficia'tis,  down-  and  outwards  across  sheath  common  carotid 
supplying  sterno-mastoid  and  adjacent  muscles  and  integu- 
ment. Larynge'a  sufic'rior  pierces  thyro-hyoid  membrane  sup- 
plying muscles,  mucous  membrane  glands,  etc.,  of  larynx  and 
epiglottis;  anas,  with  opposite  fellow.  Cr? co-thyroide1  a ,  trans- 
versely across  crico-thyroid  membrane,  anas,  with  opposite 
fellow.  Lifigualis  I  up- and  inwards  to  under  surface  of  tongue 
(ranine);  runs  parallel  with  hypoglossal  nerve.  Hyoide'a, 
along  superior  border  bone,  supplying  muscles,  anas,  with 
Opposite  fellow.  Dorsa'lls  lin'guce,  ascends  to  dorsum  tongue 
anas,  with  opposite  fellow,  supplying  mucous  membrane, 
tonsil,  epiglottis,  soft  palate,  etc.  Sublingua'lis  runs  for-  and 


ARTERIES. 


outwards  to  sublingual  gland,  supplies  it,  adjacent  muscles, 
membranes,  etc.  Rani'na,  on  lingualis  to  tip  of  tongue,  ac- 
companied by  gustatory  nerve  ;  anas,  with  opposite  fellow, 
supplying  adjacent  parts.  Facialls:  near  angle  inferior  max- 
illay  obliquely  for-  and  upwards  to  maxillary  gland,  then  up 
over  jaw,  up- and  forwards  to  angle  of  mouth,  along  side  of 
nose  to  inner  canthus  of  eye  (angular.)  CERVICAL  BRS.;  Pal- 
attnaascen'dens,  between  stylo-glossus  and  stylo-pharyngeus, 
to  outer  side  pharynx,  supplying  muscles,  tonsil,  Eustachian 
tube,  etc.;  divides,  one  branch  going  up  tensor  palati  to  sup- 
ply soft  palate,  glands,  etc.,  the  other  branch  goes  to  tonsil 
anas,  with  tonsiliar.  Anas,  posterior  palatine  of  internal  max- 
illary. Tonsilla'risi  up  to  supply  this  gland  and  root  of 
tongue.  Subntaxilla'res  (3  or  4),  supplying  this  gland  and 
adjacent  parts.  Submenta'lts,  off  just  as  facial  quits  submax- 
illary  gland,  running  forwards  upon  mylo-hyoid,  supplying  it 
and  digastric  (anas,  with  sublingual)  to  symphysis  ;  the  super- 
ficial branch  turns  round  the  chin,passing  up  to  anas,  with  infe- 
rior labial,  supplying  muscles  and  integument ;  the  deep  branch 
runs  up  on  bone  to  supply  deep  muscles  and  lip,  anas,  with 
inferior  labial  and  mental.  FACIAL  BRS.:  Muscula'res,  to  in- 
ternal pterygoid,  masseter,  buccinator.  Labia'tts  inferior  t 
beneath  depressor  anguli  Oris  to  lower  lip,  anas,  inferior 
coronary,  mental  branch  of  dental,  etc.  Corona'ria,  infe'rior 
beneath  depressor  anguli  oris  along  edge  lower  lip,  sup- 
plying adjacent  parts  and  anas,  with  opposite  fellow,  inferior 
labial,  and  mental  branch  of  inferior  dental.  Corona'ria 
superior  along  edge  of  upper  lip,  anas,  with  opposite  fellow, 
supplying  adjacent  parts,  septum  and  ala  of  nose.  Latera'lis 
wa'si,  supplying  side  and  dorsum  of  nose,  septum,  anas,  oppo- 
site fellow,  infra-orbital  and  nasal  branch  ophthalmic.  Angu- 
la'ris,  terminal  branch,  ascends  up  to  inner  canthus,  anas. 
with  nasal  branch  ophthalmic.  OccipitallS  :  from  posterior  part 
near  inferior  margin  of  digastricus,  up  between  atlas  and 
mastoid  process,  horizontally  across  occiput,  then  up  to 
vertex,  then  dividing  into  numerous  branches.  Muscula'res, 
to  digastricus,  stylo-hyoid,  stylo-mastoid,  splenius  capitis,  tra- 
chelo-mastoid.  Auricula'ris,  to  posterior  surface  concha. 
MeningJa  inferior  along  side  internal  jugular  vein  through 
foramen  lacerum  to  dura  in  posterior  fossa.  Arte'ria^rin'ceps 
cervi'cis,  descends  back  part  neck,  superficial  branch  supply- 
ing splenius  and  trapczius,  anas,  with  superficial  cervical; 
the  deep  branch  anas,  with  vertebral  and  cervical  branch  su- 
perior intercostal;  supplies  adjacent  parts.  Crania' If st  tomus-  • 


8  HEAD  AND   NECK. 

cles  and  integument  of  posterior  surface  cranium.  Atuicula'ns 
posterior :  from  above  stylo-hyoid,  ascends  beneath  parotid 
gland,  to  groove  between  mastoid  process  and  ear  cartilage, 
dividing  into  anterior  and  posterior  branches,  the  former 
passes  forwards  to  anas,  with  temporal;  the  latter,  back  to 
anas,  with  occipital.  Sty'lo-mastoide'a,  enters  do  foramen 
supplying  cells,  tympanum,  and  semi-circular  canals.  Auricu- 
la'ris,  to  back  part  of  cartilage  of  ear,  and,  penetrating,  to  its 
anterior  surface.  Pharpgs'a  aSCSn'denS  :  (smallest  branch)  deep 
seated,  arising  near  commencement  of  external  carotid,  up, 
between  internal  carotid  and  pharynx,  to  base  of  skull.  Ex- 
ternal branches,  to  recti  antici  muscles,  glands  of  neck,  sym- 
pathetic, pneumogastric  and  hypoglossal  nerves j  anas,  with 
ascending  cervical.  Pharynge'ce  (3  or  4)  to  parts  of  pharynx 
and  adjacent  muscles,  etc.  Meninge'cz  backwards  through 
foramen  lacerum  posterius,  another  branch  through  foramen 
lacerum  basis  cranii,  another  through  anterior  condyloid  fo- 
ramen to  dura  mater.  Tempora'llS  :  from  parotid  gland  up  to 
root  zygoma,  dividing  into  anterior  and  posterior.  Trans-vet's  a 
facie'i,  in  parotid  gland,  runs  across  face,  supplying  glands, 
integument  and  muscles,  anas,  with  facial  and  infra-orbital. 
Teuipora'lis  me'dia,  above  zygoma  to  temporal  muscle  and 
orbicularis,  anas,  with  lachrymal  and  palpebral  branches  of 
ophthalmic  and  deep  temporal  branches  of  internal  maxil- 
lary. Auricula'res  anterio'res  to  anterior  ear,  anas. 
with  posterior  auricular.  Tempora'lis  ante'rior  forwards  over 
forehead,  supplying  integument,  muscles,  etc.,  anas,  with 
frontal  and  supra-orbital.  Te)nporaflisJ>oste'rior,  up-  and  back- 
wards over  side  of  head,  anas,  with  opposite  fellow,  posterior 
auricular  and  occipital.  Mazilla'rij  intor'na  I  (see  external  caro- 
tid) inwards  to  inner  side  of  condyle  inferior  maxilla  into 
spheno-maxillary  fossa,  to  supply  deep  structures  of  the  face. 
MAXILLARY  PORTION  :  Ca'vi  tym'J>ani (tympanic)  up  through 
fissura  Glaseri,  supplying  membrana  tympani,  laxator  tympa- 
ni,  anas,  with  stylo-mastoid  and  Vidian.  Meninge'a.  me'dia, 
from  internal  lateral  ligament  of  jaw  up  through  foramen  spi- 
nosum,  dividing  into  anterior  and  posterior  branches,  supply- 
ing anterior  and  posterior  surface  of  dura  and  bones,  facial 
nerves,  and  branches  to  other  parts  ]  anas,  with  opposite  fel- 
low, anterior  and  posterior  meningeal.  Meninge'a  fa^i-a, 
through  foramen  ovale  to  Casserian  ganglion  and  dura  ;  also 
to  nasal  fossa  and  soft  palate.  Alveola'ris  infe'rior,  (inf.  den- 
tal) with  dental  nerve  to  foramen  on  ramus,  then  along  dental 
canal  supplying  teeth,  etc.,  till  opposite  bicuspid  tooth,  then 


ARTERIES.  9 

divides  into  incisor  and  mental  branches,  the  former  to  incisor 
teeth,  anas,  with  opposite  fellow  j  the  latter  passes  out  mental 
foramen,  anas,  wilh  inferior  labial,  inferior  coronary,  submcn- 
tal  and  supplies  adjacent  parts.  Mylo-hyoid  branch  given  off 
just  as  artery  enters  inferior  dental  foramen;  it  runs  in  its 
groove  to  its  muscle.  PETERYGOID  PORTION:  Tempera' les 
£rofun'd(Z  (2)  anterior  and  posterior  branches  up  to  temporal 
muscle.  PeterygoidJ<Kt  to  do  muscles.  Masseterlzca>  to  do 
muscle.  Bucca'lis,  to  do  muscles.  SPHENO-MAXILLARY  POR- 
TION :  Alveola'ris,  common  branch  with  following,  supplying 
(superior  dental)  teeth,  antrum  and  gums.  Infra-orbita'llst 
continuation  of  main  artery,  along  infra-orbital  canal,  and  out 
infra-orbital  foramen,  supplying  inferior  rectus  and  inferior 
oblique,  antrum,  front  teeth,  lachrymal  sac,  etc.;  anas. 
•with  facial,  buccal,  nasal  branch  ophthalmic,  etc.  Palati'na 
descen'dens,  down  posterior  palatine  canal  to  gums,  mucous 
membrane,  palate,  etc.  Vidia'na,  through  its  canal,  with 
nerve,  to  pharynx,  Eustachian  tube  and  tympanum.  Ptery- 
go-palati'nat  to  upper  part  pharynx  and  Eustachian  tube. 
Sfheno-palati'na,  (nasal),  to  mucous  membrane  of  nose,  sep- 
tum, antrum,  ethmoid  and  sphenoid  cells. 

CAUO'TIS  INTE217A  :  (8  brs.)  Superior  border  thyroid  car- 
tilage up  through  carotid  foramen  in  temporal  bone  ;  in  th^. 
skull  it  runs  forwards  in  a  course  represented  by  X  [italic  f 
laid  horizontally.]  No  branches  from  cervical  part.  Tonsil  is 
internal  to  it.  Tympan'ica :  to  tympanum.  Becoptac'nlJB :  small 
branches  to  cavernous  sinus,  pituitary  body,  Casserian  gan- 
glion, etc.  Cphthal'mica I  at  inside  anterior  clinoid  process,  for- 
wards through  optic  foramen  to  inner  canthus,  dividing  into 
frontal  and  nasal.  Lachryma'lis,  to  lachrymal  gland,  con- 
junctiva; malar  and  meningeal  branches;  anas,  freely  with 
temporal,  palpebral,  etc.  Supra-orbita'lis  t  out  supra-orbital 
foramen  to  muscles  and  skin  of  forehead  and  pericranium  ; 
anas,  with  temporal,  facial,  etc.  E.thmoida'lest  (2)  anterior 
and  posterior  to  ethmoidal  cells  and  meninges.  Palpebra'lcs, 
(2)  superior  and  inferior,  encircle  eyelids,  down  nasal  duct, 
anas,  with  temporal,  inferior  orbital,  etc.  Fronta'lisy  out  in- 
ner angle  Orbit  to  forehead,  supplying  adjacent  parts,  anas. 
with,  supra-orbital.  Nasa'lis,  to  lachrymal  sac,  then  down 
the  nose,  supplying  its  whole  surface  ;  anas,  with  facial,  etc. 
Cilia' res  bre'vest  (12 — 15)  supply  choroid  and  ciliary  processes. 
Cilia'res  lon'g&i  (2)  to  ciliary  ligament  and  iris.  Cilia'rcs 
anterio'res,  from  muscular  branches,  to  iritic  arterial  circle. 
Centra'lis  ret'inte,  pierces  optic  nerve  and  runs  in  it  to  retina. 


10  HEAD  AND  NECK. 

Muscula'res,  (2)  superior  and  inferior  to  muscles  of  eye. 
Carotri  arto'ria  aats'rforS  at  fissure  of  Sylvius  forward  in  th* 
great  longitudinal  fissure,  anas,  with  its  fellow  by  ante'rior 
ComimSn'iCans  \  curves  round  anterior  border  corpus  callosum, 
running  back  to  its  posterior  part  to  anas,  with  posterior  cere- 
bral supplying  olfactory  and  optic  nerves,  inferior  surface 
anterior  lobes,  3d  ventricle,  anterior  perforated  space,  corpus 
callosum  and  inner  surface  of  hemispheres.  Cero'tri  artc'ril 
medial  (largest  branch,)  obliquely  outwards  along  fissure  of 
Sylvius,  dividing  into  anterior  branch  to  pia  of  anterior  lobe, 
median  branch  to  small  lobe  at  extremity  of  Sylvian  fissurcj 
fostefrior branch  which  supplies  middle  lobe;  small  branches 
to  corpus  striatum  through  substantia  perforata.  Conmu'nicaia 
pOS'.c'riorl  from  back  part  of  artery  backwards,  anas,  with  pos- 
terior cerebral  of  basilar.  Ch:roi.'.e'a  ante'lior  :  from  back  part  of 
artery  back- and  outwards,  entering  descending  horn  of  lateral 
ventricle;  is  distributed  to  hippocampus  major,  corpus  fim- 
briatum  and  choroid  plexus. 

VEETEBEA'L'.S  I  (6brs.)  ist  and  largest  branch  of  subclavian. 
Enters  foramen  in  transverse  process  of  6th  cervical  vertebra 
and  ascends  in  these  cervical  foramina  to  the  axis,  then  out- 
wards, piercing  occipito-  ataloid  ligament  and  dura,  passing 
through  foramen  magnum  along  in  front  of  medulla,  unites 
•with  opposite  fellow  to  form  basilar.  Spina'les  latera'les, 
enter  spinal  canal  through  the  intervertebral  foramina  and 
supply  (anterior  branches)  the  cord  and  membranes  and  (pos- 
terior branches)  posterior  surface  of  vertebral  bodies.  Mus- 
cula'rfsi  deep  muscles  of  neck,  anas,  with  occipital  and  deep 
cervical.  Posterio'res  meningefcet  (2)  to  falx  cerebelli.  Spi- 
na'lis  anterior,  given  off  near  termination,  unites  with  oppo- 
site fellow,  and  descends  on  cord,  anas,  with  spinal  branches 
through  the  intervertebral  foramina  down  to  sacrum.  Supplies 
pia  of  cord  (being  placed  beneath  it)  and  cord.  Spina'lis  pos- 
te?riort  arises  at  side  of  medulla  and  passes  down  posterior  sur- 
face of  cord,  being  reinforced  similarly  to  the  anterior  spinal, 
to  sacrum.  Inferior  cerebella'ris>  winds  back  over  medulla, 
to  under  surface  of  cerebellum,  there  dividing,  the  inferior 
branches  going  backwards  to  notch  between  the  two  hemis- 
pheres, the  external  branch  supplying  the  inferior  surface- 
anas,  with  superior  cerebellar;  branches,  also  to  choroid  plexus, 
4th  ventricle. 

B  ASILLA'BIS  I  (see  above)  from  posterior  to  anterior  borders 
ofpons,  there  dividing  into  posterior  cciebral.  Transver'scCf 
to  ponSj  internal  auditory  meatus,  under  surface  cerebellum 


(ant.  cerebellar).  Superior  cerebella'rist  near  end  basilar,  up 
over  cerebellum,  supplying  it,  pineal  gland,  velum  interposi- 
tum.  Paste' riorcerebra' Us,  winds  round  crus  cerebri  to  infe- 
rior surface  of  posterior  cerebral  lobes,  supplying  them,  and 
chorold  plexus,  anas,  with  anterior  and  middle  cerebral. 

Circle  Of  Willis:  (10);  from  behind  forwards:  basilar,  2  pos- 
terior cerebral,  2  posterior  communicating,  2  internal  carotids, 
2  anterior  cerebral,  anterior  communicating. 

Jnfs'rior  Thyroide'a  I  (see  arteries  of  upper  extremity)  branch 
of  thyroid  axis,  up  behind  sheath  of  common  carotid  and  sym- 
pathic  nerve  to  under  surface  of  thyroid  gland,  anas,  with 
opposite  fellow,  and  superior  thyroid.  Laryngea'lis,  to  back 
part  larynx.  Tracheci'les,  to  trachea,  anas,  with  bronchial. 
(Esophagea'les.  Cervica'lis  ascen'dens,  up  neck,  supplying 
muscles,  vertebrae,  cord  and  membranes. 

Cervi'ciS  profi-'da:  (see  arteries  of  upper  extremity)  branch 
of  superior  intercostal,  ascends  back  part  of  neck,  below  corn- 
plexus,  to  axis,  supplying  adjacent  parts,  and  anas,  with 
branches  of  vertebral  and  princeps  cervicis  of  occipital. 

VEINS. 

Ve'na  LiploSS:  walls  only  of  epithelium,  with  many  cuh-de- 
sacs.  Fro::ta'liS)  opens  into  supra-orbital  through  supra-orbital 
notch.  Tempora'lis  ante'rior  opens  into  deep  temporal.  Ton- 
Pora'lis  posterior  confined  to  parietal  region,  opens  into 
lateral  sinus.  Occipiia'lis,  opens  into  occipital  vein  or  sinus. 

Cerebralea  I  noted  for  their  thin  coats,  muscular  tissue  and 
absence  of  valves.  Superidrcs,  (j  or  8  on  each  side)  for-  and 
inwards  to  superior  longitudinal  sinus,  there  receivinginterior 
cerebral  which  drain  the  same  hemisphere.  Inferio'res  antcri- 
f/rest  under  surface  of  anterior  lobes  ;  terminate  in  cavernous 
sinus.  Inferirfres  latera'les,  (3  to  5)  terminate  in  lateral  sinus- 
Inferitfres  Metdia,  from  posterior  lobe,  etc.,  to  straight  sinus 
behind  venae  Galeni.  Vo'ns  Cale'ni(2,  one  from  right,  one  from 
left  ventricle)  formed  by  vc'na  corpo'ris  stria'ti  and  ve'na 
choroide'a;  pass  back  and  out  of  transverse  fissure  to  straight 
sinus.  Cerebella'res,  superior,  inferior  and  lateral  sets  ;  the 
ist  open  into  straight,  the  zd  into  lateral,  the  3d  into  superior 
petrosal  sinus. 

Si'HUS  :  (16  in  No.)  Sufie'rior  longiiudina'lis,  beings  at  crista 
Galli,  runs  back  over  cerebrum  to  torcular  Herophili ;  receives 
superior  cerebral  and  parietal  veins.  Infe'riorlong':tudina'lis9 
along  posterior  part  free  margin  of  falx  cerebri  to  straight 
sinus.  Tento'rii  (straight),  junction  of  tentorium  and  falx 


13  HEAD  AND  KECK. 

cerebri  to  torcular  Herophili ;  receives  inferior  longitudinal 
sinus,  venae  Galeni,  inferior  median  cerebral,  and  superior 
cerebellar  veins.  Latera'les,  (2)  from  torcular  to  foramen 
lacerum  posterius  into  internal  jugular  vein,  receives  straight 
and  occipital  sinus,  etc.  Occipita'les,  (2)  smallest ;  posterior 
margin  of  foramen  magnum  to  torcular.  Caver*  ni,  (2)  sides  of 
sella  Turcica  from  sphenoid  fissure  to  apex  petrous  part  of 
temporal.  Receives  ophthalmic  vein  connecting  the  frontal 
with  these  sinus;  also  inferior  anterior  cerebral  veins.  Cir~ 
cula'ris,  surrounds  pituitary  body,  communicates  with  each 
cnvernous.  Inferio'res petrosa'les^z}  termination  of  cavernous 
to  intenal  jugular  vein.  Transver'sus,  connects  the  inferior 
petrosales  across  basilar  process  of  occipital.  Superio'res jt>etro- 
sa'les,  (2)  on  superior  border  petrous  part  of  temporal,  con- 
necting lateral  and  cavernous ;  receives  inferior  lateral  cere- 
bral, anterior  lateral  cerebellar  veins. 

Ve'na  Facia'liS :  obliquely  across  side  face  from  inner  can« 
thus,  to  unite,  under  inferior  maxilla,  to  form  a  trunk  for 
internal  jugular.  Receives  supra-orbita'lis,  supra-falpebra'lis, 
nasa'lis,  inferior  Jalpebra'lis,  fronta'lzs,  supra-orbitalis  , 
supra-labia'lis,  inferior  labia'lis,  bucca'lis,  masseter'ica,  sub" 
menta'iis,  infe'rior  palati'na  (which  arises  from  plexus  about 
tonsil,  etc.),  submaxilla'ris,  ranfna;  also  communicates  with 
ophthalmic  (see  cavernous  sinus). 

Tempora'lis :  from  side  and  vertex  of  head,  uniting  with 
internal  maxillary  forms  temporo-maxillary.  Receives  faro- 
tide'cet  anterio'res  auricula'res,  transit er'sa  facial. 

Mizilla'ris  Inter'na:  me' dice  meninge'te,  tempora'lis prcfun'da, 
fterygoidc'a,  masseter'ita,  bucca'lis,  palati'na:,  infe'rior  den- 
ta'lis,  forms,  with  above,  temporo-maxillary. 

Temporo-Mazilla'rlS :  union  of  temporal  and  internal  maxilla- 
ry, descends  in  parotid  gland  and  divides,  one  branch  going 
to  join  facial,  the  other  to  external  jugular.  Receives  poste- 
rior auricular. 

FOito'rior  auricda'ris :  plexus  side  of  head,  receives  stylo- 
mastoide'a.  and  branches  from  external  ear;  empties  into  tem- 
poro-maxillary. 

Occipita'liS  I  (from  plexus),  back  part  vertex  of  skull  deeply 
between  muscles  of  neck  lying  in  course  of  artery,  to  internal 
jugular.  Receives  tnastoide'a^  which  communicates  with  lat- 
eral sinus. 

Jttgnla'riS  Ezter'na :  from  temporo-maxillary  near  angle  lower 
jaw,  down  into  subclavian  accompanied  by  auricularis  magnus 
nerve.  Has  2  pair  of  valves.  Receives  occifiita'liS)  foste'rior 


NERVES.  13 

jugula'ris  exter*na  (draining  superficial  muscles  of  back  of 
neck),  supra-scapuia'ris ,  transver'sa.  cervi'cis. 

Ante'rior  jugula'ris !  drains  integument  and  superficial  mus- 
cles of  anterior  and  middle  portion  of  neck,  emptying  into 
subclavian.  No  valves. 

JnguL'riS  Lter'ni:  from  jugular  foramen  at  junction  of  lat- 
eral and  inferior  petrosal  sinus,  vertically  down  the  side  of 
neck  (outer  side  of  main  arteries),  uniting  with  subclavian  tc 
form  vena  innominata ;  i  pr.  valves,  ^  inch  above  termination. 
Receives/«£/V/z.r,  lingua' Us, pharynge'cz^  superior  thyroid*' a t 
rue1  dia  thyroide'a. 

Vcrtebra'llS :  drains  occipital  region  and  deep  muscles  of 
back  of  neck  ;  enters  foramen  in  transverse  process  of  atlas 
down  through  similar  foramina  of  the  cervical  vertebrae  to  6th 
(or  jth)  where  it  passes  out  to  enter  v.  innominata.  Receives 
posterior  condyloi' da,  imtscula'rcs,  dorso-spina'les,  menin'gio- 
racktdza'nfr,  ascen' dens  and  prof un' da  cervica'les.  i  pr.  valves 
guard  its  mouth. 

NERVES. 

CRANIAL.  Isi  or  Nsr'vus  olfac'wUS.— From  corpus  striatum, 
middle  and  anterior  lobes  of  cerebrum.  Supplies  the  Schnei- 
derian  membrane.  Special  function,  smelling. 

2cl  or  Qp'ticus. — From  optic  thalami  and  the  corpora  genic- 
ulata  ct  quadrigemina,  out  through  optic  foramen  to  retina. 
Special  function,  sight. 

3d  or  Moto'rius  Cc'uli.— From  crus  cerebri  and  pons  (?)  out 
through  foramen  lacerum  anterius  to  all  the  muscles  of  the 
orbit,  save  the  superior  oblique  and  external  rectus;  a  few 
filaments  pass  to  the  iris.  Is  a  motor  nerve. 

4. h  cr  Pathet'icu:.  — From  valve  of  Vieussens,  through  fora- 
men l.icerum  anterius  to  superior  oblique.  Is  a  motor. 

5.h  or  Trigeni'iniS. — The  sensory,  or  posterior  root,  from  the 
lateral  tract  of  the  medulla,  the  pons,  and  cerebellum  (middle 
peduncle).  The  motor  root  from  the  pyramidal  body.  The 
sensory  supplies  are  to  the  eye-ball  (iris,  ciliary  body,  etc), 
lachrymal  gland,  conjunctiva,  Schneiderian  membrane,  all 
the  muscles  and  integument  about  the  eye-ball,  o:bit,  cs  fron- 
talis,  nose,  mouth,  cheek,  lips,  temple,  superior  portion  of 
pharynx,  tongue,  gums,  and  teeth.  Motor  filaments  are 
given  to  the  external  and  internal  pterygoid,  temporal,  bucci- 
nator, and  masseter  muscles.  Special  sensation  (taste)  to 
mucous  membrane  of  mouth,  gums,  tongue  (anterior  and  mid- 
dle portion),  sub-lingual  gland,  conical  and  fungiform  papillae. 


14  HEAD  AND   NECK. 

BRS.—I.  OPHTHAL'MICUS:  sensory;  forward  through  sphenoidal 
fissure  from  Casserian  ganglion,  joined  by  cavernus  plexus  of 
sympathetic.  Lachryma'lis*  Fronta'lis\  (a)  supra-trochlea'ris, 
(3)  supraorbital.  Nasa'lis  ;  ganglionic,  long  ciliary  (2  or  3), 
infra- trochlear  branches.  n.  SUPE'RIOR  MAXILLA'RIS  ;  sen- 
sory :  forwards  through  foramen  rotundum  from  Casserk.n 
ganglion  appearing  on  face  through  infra-orbital  foramen. 
Orbita'iis\  (a)  temporal,  (b]  malar  branches.  Sjheno-palati'ni 
(2).  Posteritfrex  dcnta'les  (2);  (a)  anterior  branches,  (b}  posterior 
branches.  Ante'rior  denta'lis.  Palpebra'les.  Kasa'les.  La- 
lia'les.  All  inosculate  with  branches  from  facial,  in.  IN- 
FE'RIOR  MAXILLA'RIS:  sensor  root  from  Casserian  ganglion, 
motor  unites  with  it  after  passing  through  foramen  ovale. 
ANTERIOR  DIVISION:  (a)  masseteric,  (b)  deep  temporal,  (c) 
buccal,  (d)  ptcrygoid  branches.  POSTERIOR  DIVISION:  Auric- 
ulo'temfora'iis  ;  (#)  anterior  temporal,  (b)  posterior  temporal 
(out  under  cover  of  parotid),  (c)  communicating  with  facial, 
(d)  inferior  and  superior  auricular,  (e)  2  branches  to  meatus, 
(/)  branches  to  temporo-maxillary  articulation,  (^branches 
to  parotid  gland.  Gustato'rius ,  side  of  tongue  to  lip;  (a) 
communicating  branches,  (b)  branches  of  distribution  to 
tongue,  gums,  etc.  '  Infe'rior  denta'lis,  in  dental  canal  inferior 
maxilla  to  teeth,  etc.;  (a}  mylo-hyoid  to  do  muscle,  etc.,  (b) 
dental  branches. 

£ft  or  Atdu'ccnS.— From  pons,  corpus  pyramidale  and  me- 
dulla through  foramen  lacerum  anterius  to  supply  motor  in- 
fluence to  the  rectus  externus  oculi. 

7.h  or  Facia'l'.S.  -  From  lateral  tract  medulla  and  4th  ven- 
tricle, out  through  stylo-mastoid  foramen  to  all  the  muscles  of 
the  face,  ear  and  their  integument,  the  platysma,  buccinator, 
digastric,  stylo-hyoid,  lingualis,  stapedius,  laxator  and  tensor 
tympani,  levator  palati,  and  azygos  uvulae.  Is  essentially  a 
motor  nerve.  Tytn^an'tcus.  Chor'da  tym'pani.  Posterior 
auricula' r is;  (a)  auricular  branch,  (b)  occipital  branch.  Stylo- 
hyoidefus.  Digastric  branch.  Temforo-facia'lis;  (a)  tem- 
poral branches,  (£}  infra-orbital,  (superficial  and  deep 
branches),  (c)  malar  branches.  Ccrvico-facia'lis  ;  (a)  buccal, 
(3)  supra-maxillary  branches,  (c)  infra-maxillary  branches. 

8ti  or  I.  Glosso-;har;n23'tis,  II.  Pnsuzoga:'tricns,  III.  Spisa'lis 
AccaS30'rU3.  —  i.  and  ii.  from  floor  of  4'>.h  ventricle;  in.  from 
lateral  tract  of  cord  as  low  as  6th  cervico-spinalis,  and  also 
from  medulla  just  below  origin  of  I.  and  n.  Part  i.  passes 
Out  through  foramen  lacerum  posterius  to  supply  sensation  to 
mucous  membrane  of  pharynx,  fauces,  Eustachian  tube, 


tympanum,  and  tonsil;  motor  influence  to  the  pharyngeal 
muscles ;  gustation  to  posterior  third  of  tongue  and  its  lateral 
papillae.  Branches  of  communication  (sympathetic,  facial,) 
tympanic);  Carotid  branches.  Pharyngeal  branches.  Mus- 
cular branches.  Tonsillar  branches.  Lingual  branches. 
Part  ii,  through  foramen  lacerum  posterius  to  supply  motor 
and  sensor  filaments  to  the  muscles  and  parts  about  the 
pharynx,  larynx  and  trachea  concerned  in  speech  and  respi- 
ration ;  motor  filaments  to  the  pharynx,  heart,  oesophagus, 
stomach,  and  filaments  to  the  splenic  and  hepatic  plexi.  Au- 
ricula? r  is.  Pharyngeal  branch.  Superior  laryngea'lis.  Re- 
cur9 rens  (or  inferior  laryngea'lis  (the  motor  of  larynx).  Cervi- 
co-cardiac  (2  or  3  in  number).  Thoracico-cardiac.  Anterio'res 
fulmona'res  (2  or  3  in  number.)  Posterior  pulmona'ris.  CEso- 
fhagea'les.  Gastric  branches.  Part  in.  supplies  motor  fila- 
ments to  sterno-mastoideus  and  trapezius.  The  accessory 
part  arising  from  lateral  tract  of  cord,  the  spinal  portion  as 
low  down  as  6th  cervical  nerve,  passing  up  in  spinal  foramen 
into  skull,  then  out,  with  the  accessory  portion,  through  jug- 
ular foramen. 

.9thorHyp:glos'SUS. — From  floor  of  medulla.  Is  the  motor  ol  the 
tongue.  Out  through  anterior  candyloid  foramen  to  supply  the 
genio-hyoid,  genio-hyo-glossus,  hyo-glossus,  stylo-glossus, 
thyro-hyoid,  sterno-hyoid,  omo-hyoid,  and  sterno-thyroid 
muscles.  Is  deep-seated  (beneath  internal  carotid),  but  finally 
curves  over  externally  to  the  carotid  to  muscles  for  distribution. 
Has  branches  of  communication  with  pneumogastric,  sympa- 
thetic, ist  and  2d  cervical  and  gustatory.  Dcscen'dens  ncfni 
(on  carotid  sheath),  joining  with  ad  and  3d  cervical.  Thyro- 
hyoid  branch.  Muscular  branches. 

CiRVICA'LES:  each  increase  in  size  from  i&t  to  5th ;  8  pairs 
in  all.  Have  anterior  and  posterior  branches,  the  latter  hav- 
ing ganglionic  enlargements.  The  ist,  or  sub~occipitalt  (ante- 
rior branch)  has  exit  between  atlas  and  occiput,  the  remain- 
ing 7  between  their  respective  vertebrae.  The  4  upper  (ante- 
rior branches)  unite  to  form  the  cervical  plexus;  the  4  lower 
(anterior)  with  the  ist  dorsal  form  the  brachial  plexus. 

CerTi'ciSp'es'us;  SUPERF.  BRS.  Super/id  a' Us  col' It  t  from  ad 
and  3d;  obliquely  forwards  to  anterior  and  lateral  parts  of 
neck.  Auricula'ris  mag'nus,  from  ad  and  3d ;  ascends  to 
parotid  gland,  having  facial,  posterior  auricular  and  mastoid 
branches.  Occipita'lis  m?nort  from  ad;  ascends  to  side  of 
head;  has  auricular  branch.  Supra-clavicula'res,  from  3d  and 
4th;  downwards,  having  sternal,  clavicular,  and  acromial 


l6  HEAD   AND   NECK. 

branches.  DEEP  BRS.:  Communican'  tea  s  loop  between  ist 
and  ad,  to  sympathetic,  hypogiossal,  pneumogastric,  and 
spinal  accessory  nerves.  MuscuJa'res,  from  ist.  Commu'nt- 
cans  no'ni,  from  2d  and  3d,  uniting  with  descendens  noni. 
2^hren!tcust  from  3d,  4th  and  5th  |  crosses  subclavian  artery 
down  to  middle  mediastinum,  thence  to  pericardium,  dia- 
phragm and  pleura.  The  left  is  the  longer.  POSTERIOR 
BRANCHES:  each  have  external  and  internal  divisions  sup- 
plying the  muscles  of  the  back  of  the  neck,  etc.  Sub-occiJ>i- 
ia'lis,  from  ist,  up  to  sub-occipital  region.  Occipita'lis  ma'jor, 
the  internal  branch  from  the  2d  cervical.  Occipital  branch, 
from  the  3d  cervical,  internal  branch.  All  the  others  havfc 
only  the  external  and  internal  branches,  supplying  the  mus- 
cles contiguous  to  them. 


EXTREMITY. 

MUSCLES. 

(l)   ANTERIOR   THORACIC   REGION    3. 

PeC'.OriliS  ma'jor:  sternal  half  clavicle,  %  front  of  sternum 
down  to  7:  h  rib,  cartilage  of  true  ribs,  aponeurosis-  external 
oblique  —  anterior  bicipital  ridge  of  humerus.  [Anterior  tho- 
racic.] 

Pectoral!]  mi'no:  :  3d,  4th  and  sth  ribs—  anterior  border  cora- 
coid  process  of  scapula.  [Anterior  thoracic.] 

Subcla'viUS  I  ist  rib-cartilage  —  under  surface  middle  3d  of 
clavicle.  [Branch  from  5th  and  6th  cervical.] 

(2)   LATERAL  THORACIC   REGION    I. 

S^ira'tllS  Juag'miS  \  9  digitations  frcm  the  8  superior  ribs— 
whclj  length  inner  margin  scapula,  posterior  surface.  [Poste- 
rior thoracic.] 

(3)  ACROMIAL  REGION   I. 

Del'oide'ui:  outer  36.  anterior  border,  upper  surface,  of 
clavicle  ;  outer  margin,  upper  surface  acromian  crocess;  whole 
length  lower  border  spine  of  scapula  —  prominence  outer  sur- 
face (middle)  humerus.  [Circumflex.] 

(4)    ANTERIOR    SCAPULAR    REGION    I. 

Ehibscaptlla'ris  :  inner  %  subscapular  fossa—  lesser  tuberosity 
humerus.  [Subscapular.] 

(5)   POSTERIOR  SCAPULAR    REGION  4. 

Supra-Sp'na'ttlS  :  internal  2/£  of  supra-spinous  fossa  of  scapula 
—  upper  facet  greater  tuberosity  humerus.  [Supra-scapu- 
lar.] * 

ZafrSrEpfca'ttlS  !  internal  %  of  infra-spinous  fossa  —  middle 
facet  greater  tuberosity  humerus.  [Supra-scapular.] 


tai'aor!  dorso-axillary    border  scapula — lowest   facet 
greater  tubcrosity  of  humerus.     [Circumflex.] 

Te'res  ma'.or  :  dorsum  inferior  angle  scapula — posterior  bicip- 
ital  ridge  humerus.  [Subscapular.J 

(6)  ANTERIOR   HUMERAL   REGION   3. 

Cfl^CO-bracllia'lis:  apex  coracoid  process  scapula  —  rough 
ridge  inner  (middle)  side  of  humerus.  [Musculo-cutaneous.] 

Bi'csps  :  long  head  above  glenoid  cavity;  short  head,  cora- 
coid process — bicipltal  tuberosity  radius.  [Musculo-cutaneous.] 

Braci'a'.iS  anti'CUS:  lower  half  outer  and  inner  surfaces 
shaft  humerus,  septa — under  surface  coronoid  process  ulna. 
{Musculo-cutaneous,  musculo-spiral.] 

(7)  POSTERIOR   HUMERAL    REGION  9. 

Tri'cepS  :  long  head,  depression  below  glenoid  cavity ;  ex- 
ternal head,  posterior  superior  part  of  humerus ;  internal 
head,  posterior  surface  of  humerus  below  musculo-spiral 
groove — olecranon  process  ulna.  [Musculo-spiral] 

S^anCOHS'TlS  \  j  ust  above  olecranon  fossa  humerus — posterior 
ligament  elbow-joint.  [Musculo-spiral.] 

(8)    ANTERIOR  BRACHIAL  REGION,  SUPERFICIAL  LAYER,  5. 

Prona'tor  ra'dii  to'reS  I  above  internal  condyle  humerus,  com- 
mon flexor  tendon,  fascia,  inner  side  coronoid  process  ulna — 
rough,  ridge  radius,  outer  (middle)  surface.  [Median.] 

Flex'or car'pi  radia'lis:  common  flexor  tendon,  internal  con- 
dyle humerus,  fascia — base  of  index  metacarpal.  [Median.] 

Falma'riS  lon'gUS  .  common  internal  condyloid  (humerus) 
flexor  tendon,  fascia— annular  ligament  and  palmar  fascia. 
[Med  an.] 

Flos'or  car'pi  ulna'ris :  isthead,  common  flexor  tendon  inter- 
nal conUyle  humerus ;  ad  head,  internal  margin  olecranon — 
pisiform  bone.  [Ulnar.] 

Flex'OP  SUbli'miS  dgito'rnm:  ist,  internal  condyle  humerus 
(common  flexor  tendon);  2d  head,  inner  side  coronoid  process 
ulnaj  3d  head,  oblique  line  radius — lateral  margins  ad  pha- 
langes, tendon  split  for  passage  of  flexor  profundus  digitorum. 
[Median.] 

(9)   ANTERIOR    BRACHIAL    REGION,    DEEP  LAYER,  3. 

Flex'or  proftm'dllS  d'g'to'mm:  upper  %  anterior  and  inner  sur- 
face ulna,  inner  side  coronoid  process,  interosseous  membrane 
— bases  last  phalanges.  [Ulnir,  anterior  interosseous.] 

Phz'OT  loa'gM  polCciS :  upper  %  anterior  surface  radius, 
interosseous  membrane— base  last  phalanx  thumb.  [Anterior 
interosseous.] 

Frona'tor  quadra'tus :  oblique  line  and  lower  4th  ulna — lower 

2 


l8  UPPER   EXTREMITY. 

4th  anterior   surface  and  external  border  radius.    [Anterior 
interosseous.] 

(lo)  RADIAL  REGION  3. 

Supina'tor  lon'gUS  :  upper  %  external  condyloid  ridge  hume- 
rus, septum — styloid  process  radius.  [Musculo-spiral.] 

Exten'sor  car'f  i  sadiallS  l:n'gior:  lower  third  external  condy- 
loid ridge  humerus,  septum — base  metacarpus  indicis.  [Mus- 
culo-spiral.] 

Ezten'sor  car'pi  radialis  brs'vior :  common  tendon  external 
COndyle  humerus,  external  lateral  ligament,  septa — base 
metacarpus  middle  finger.  [Posterior  interosseous.] 

(ll)   POSTERIOR    BRACHIAL   REGION,   SUPERFICIAL  LAYER,   4. 

Exten'SOr  COmmu'n'S  dig.to'rum:  common  tendon  external  coa- 
dyle  humerus,  septa— zd  and  3d  phalanges.  [Posterior  interos- 
seous.] 

Elt2n'S:r  minimi  dlg'iti:  external  condyle  humerus,  septa- 
unites  with  tendon  extensor  communis  digitorum  to  be  insert- 
ed into  zd  and  3d  phalanges  of  little  finger.  [Posterior  inter- 
osseous. 

Exten'SOr  Car'pi  Ulna'ris :  common  tendon  external  condyle 
humerus,  middle  3d  posterior  border  ulna,  fascia — base  5th 
metacarpus.  [Posterior  interosseous.] 

AiCOae'US!  back  part  outer  condyle  humerus— side,  olecra- 
non  and  upper  posterior  3d  ulna.  [Musculo-spiral.] 

(l2)  POSTERIOR     BRACHIAL  REGION,    DEEP  LAYER,    5. 

5:pina'tor  tre'vis  I  external  condyle  humerus,  external  lat- 
eral and  orbicular  ligaments,  oblique  line  ulna — (surrounds 
radius  at  its  upper  part)  back  part  inner  surface;  outer  edge 
bicipital  tuberosity  ;  oblique  line  of  radius.  [Posterior  inter- 
osseous.] 

Exten'sor  os'sis  metacar'pi  pol'licis:   posterior   surface  shaft 

ulna  and   radius   (middle   3d),   interosseous   membrane — base 
XSt  metacarpus.     [Posterior  interosseous.] 

E-tea'sor  pri'mi  intorno'dii  p:l'lici3!  posterior  surface  radius, 
interosseous  membrane — base  ist  phalanx  of  thumb.  [Poste- 
rior interosseous.] 

E*:ea'sor  secun'di  hteno'dii  pcllicis :  posterior  surface  ulna, 

interosseous   membrane — base  ad  phalanx  thumb.     [Posterior 
interosseous.] 

Ex  ez/sor  in'iici::  posterior  surface  ulna,  interosseous  mem. 
brane— joins  tendon  extensor  communis  digitorum  to  ad  and 
3d  pLalanges  indiois.  [Posterior  interosseous.] 

(13)  THUMB,   RADIAL  REGION,    4, 

AbiUC'tor  pol'lic'S :  ridge  trapezium  and  annular  ligament- 
radial  side  base  ist  phalanx  thumb.  [Median.] 


OppO'neB3  po'.licis :  palmar  surface  trapezium,  annular  liga- 
ment—whole length  ist  metacarpus,  radial  side.  [Median.] 

FlQZ'or  brQ'vlS  jol'licis  :  trapezium,  outer  %  annular  ligament, 
trapezoid,  os  magnum,  base  3d  metacarpus,  tendon  flexor 
carpi  radialis — both  sides  base  ist  phalanx  thumb.  [Median, 
ulnar.] 

Adduc'tOP  po'.'licis  :  whole  length  3d  metacarpus — ulnar  side 
base  ist  phalanx  thumb.  [Ulnar.] 

(14)    LITTLE   FINGER,    ULNAR    REGION,    4. 

Palma'ris  bre'u;: :  annular  ligament  palmar  fascia — skin  inner 
border  p.ilm.  [Ulnar.] 

Abd:c'  or  min'.mi  dig'iti:  pisiform  bone,  tendon  flexor 
carpi  ulnaris  —  ulnar  side  base  ist  phalanx  little  finger. 
[Ulnar.] 

Flex'or  bre'viS  minimi  dig'iti  I  tip  unciform,  process  annular 
ligamen  t — base  ist  phalanx  little  finger.  [Ulnar.] 

Oppo'neis  min'imi  dig'iti:  unciform  process  annular  ligament 
— ulnar  side  sth  metacarpus.  [Ulnar.] 

(15)    MIDDLE   PALMAR   REGION   3. 

Lnmb  ica'Ies  :  (4) ;  accessories  to  flexor  profundus  digitorum 
— tenu  n  extensor  communis  digitorum.  [Median and  Ulnar.] 

I  teros':ei  dor-a'.eSS  (4)  J  metacarpi— base  ist  phalanges  ist, 
ad,  3d  fingers.  [Ulnar.] 

Intero^'sei  pa'ma'res  :  (3);  ad,  4th  and  5th  metacarpi— ist  phal- 
anges of  same  fingers.  [Ulnar.] 


ARTERIES. 

SUB'CLAVIA:  (4  brs.)  Right,  i.  from  innominate  at  sterno- 
clavicular  articulation  to  inner  margin  scalenus  anticus. 
(Le/t,  i.  from  transverse  portion  aortic  arch  opposite  zd  dorsal 
vertebra  toscalenusanticus);n  internal  border  scalenus  anticus 
to  outer  of  scalenus  medius  in.  from  external  border  scalenus 
medius  to  lower  border  ist  rib,  midway  along  clavicle.  Verte- 
bra'lis,  upper  and  back  portion  of  part  I. — enters  foramen  6th 
cervical  vertebra  to  be  continued  upwards  (see  page  10).  Thy- 
roide'U3  ax'iS,  anterior  part  of  first  portion,  inner  side  scalenus 
anticus.  Infe'rior  thyroide'a  (see  page  n).  Tr answers  a' Us 
col'li,  (a)  superficial  cervical  beneath  anterior  margin  trape- 
zius— to  trapezius  and  glands  in  that  region,  (b)  Poste'rior 
scapula'ris  to  superior  angle  of  scapula  to  anastomose  at  the 
inferior  angle  with  subscapular.  Su^ra-scajuta'ris— outwards 
and  backwards  parallel  with  clavicle  to  supra-spinous  fossa  ; 
distributed  to  muscles  in  that  region.  Stern a'lis  inter'na  (mam- 
mary), origin  just  below  thyroid  axis,  behind  clavicle  along 


20  UPPER  EXTREMITY. 

inside  chest  to  6th  intercostal  space,  there  dividing  into  mus- 
culo-phrenic  and  superior  epigastric.  Co'mes  ner'viphren'ici, 
to  diaphragm;  anastomoses  with  other  phrenic  branches.  Me- 
diastina'les,  to  areolar  of  anterior  mediastinum,  also  remains  of 
thymus.  Pericardia' les,  to  upper  pericardium,  triangularis 
sterni,  anas,  musculo-phrenic.  Anterio'res  intercosta'les,  to 
5  or  6  tipper  intercostal  spaces,  to  intercostal  and  pectoral 
muscles  and  mammary  gland;  anas,  aortic  intercostal.  Per- 
foran'tes,  to  5  or  6  upper  intercostal  spaces,  to  pectoral  mus- 
cles and  mammary  gland.  Mus' culo-phren' ica ,  perforates 
diaphragm  at  8th  or  pth  rib,  supplying  intercostal  spaces,  dia- 
phragm and  abdominal  muscles.  Epigas'trica  supe'rior — 
down  behind  rectus  to  supply  that  muscle  and  others  near  it; 
anas,  with  inferior  epigastric.  Supe'rior  int;rc:sta'les,  upper  and 
back  portion  lid  part  to  ist  and  2d  intercostal  spaces,  supply- 
ing spinal  muscles  and  cord  ;  anas,  aortic  intercostals.  Pro* 
fun'da  cervi'cis— back  to  7th  cervical  vertebra  and  between 
complexus  and  semi-spinalis  colli  runs  to  axis,  supplying  con- 
tiguous muscles,  anas,  anterior  princeps  cervicis. 

AXILLA'EIA:  (7  brs.)  lower  border  ist  rib  to  tendons  latissi- 
mus  dorsi  and  teres  major  ;  ist  part,  ist  rib  to  pect.  minor  j 
lid,  from  superior  border  pectoralis  minor  to  inferior  border 
same  ;  md,  from  inferior  border  pectoralis  minor  to  tendon 
latissimus  dorsi.  Sups'rior  T-Orac'ica,  1st  part — forwards  and  in- 
wards along  superior  border  pectoralis  minor,  supplying  pec- 
toral muscles;  anas,  internal  mammary  and  intercostal.  AcrO- 
ffiia1:S  T_0rac'-Ca,  ist  part  to  upper  border  pectoralis  minor  ; 
Acromia'Us,  towards  acromian  process  to  deltoid ;  anas,  su- 
prascapular  and  posterior  circumflex.  Thorat' ictz ,  2  or  3  in 
number,  supplying  serratus  magnus  and  pectoral  muscles  } 
anas,  intercostals  of  internal  mammary.  Desc:nding\>r2cn.z\\ts 
supply  pectoralis  major  and  deltoid,  as  accompanying  cephalic 
vein.  Thorac'.ca  loa'ga,  n.  part,  down-  and  inwards  along  inferior 
border  pectoralis  minor  to  pectoral  muscles,  axillary  and  mam- 
mary glands,  serratus  magnus  and  subscapulnris  ;  anas,  inter- 
nal mammary  and  intercostal.  ThwaC'lCl  ala'r  S,  n.  part,  to 
glands  and  areolar  tissue  of  the  axilla.  Subscapu  a'rifl,  in.  part, 
opposite  inferior  border  do  muscle,  down  and  b.tck  Inferior 
margin  do  muscle  to  inferior  angle  scapula  ;  anas,  posterior 
scapular.  Dorsa'lis  scap'ulce — dividing  into  3  branches,  "sub- 
scapular,"  "infra-spinous,"  and  "median."  Altogether  they 
supply  the  scapular,  latissimus  dorsi  and  serratus  magnus 
muscles.  Make  a  general  anastomosis.  Posto'rio:  CirC"mfles'a, 
opposite  inferior  border  subscapularis,  winds  round  neck 


humerus  to  supply  deltoid;  anas,  anterior  circumflex,  suprs- 
scapular,  acromio-thoracic.  Ante'ritr  Circumfles'a,  just  below 
above,  passes  anterior  to  humerus  supplying  deltoid  ;  anas. 
posterior  circumflex,  acromio-thoracic. 

BB~CZXA'LIS :  (5  hrs.)  inferior  border  teres  major  to  y2  inch 
below  bend  of  elbow.  Runs  along  inner  border  biceps  and 
coraco-brachialis  ;  is  superficial.  Supe'rior  pr  fun'da,  opposite 
inferior  border  trocbanter  major,  winds  backwards  in  spiral 
groove  down  to  elbow ;  anas,  recurrent  radial;  supplies  del- 
toid, coraco-brachialis,  triceps.  Posterior  articula'ris>  per- 
pendiculary  down  to  back  of  elbow-joint ;  anas,  interosseous 
recurrent,  posterior  ulnar  recurrent,  anastomotica  magna. 
ITutri'cia,  middle  of  arm  to  bone  near  insertion  coraco-brachialis. 
Ini.'ri.r  pro.un'da,  just  below  middle  arm  to  anas,  posterior 
uluar  recurrent  and  anastomotica  magna  at  elbow  ;  accom- 
panied by  ulnar  nerve.  Anas  omot'ica  mag'ni,  2  inches  above 
elbow-joint  winds  round  and  down  humerus  to  elbow-joint ; 
anas,  posterior  ulnar  recurrent,  inferior  profunda,  anterior 
ulnar  recurrent.  Muscula'reS,  3  or  4,  to  coraco-brachialis,  brachia- 
lis  anticus. 

.  BADIA'LIS:  (12  brs.)  end  of  the  brachialis  down  radial  side 
forearm,  along  inner  border  supinator  longus  to  wrist ;  then 
winds  around  carpus  beneath  thumb-extensors  to  enter  palm 
of  hand  between  thumb  and  index  finger  to  form  "deep  pal- 
mar arch":  anas,  deep  branch  of  ulnar.  Eadia'lis  16  ur'rens, 
below  elbow — up  arm  supplying  brachialis  anucus,  supinator 
longus,  supinator  brevis,  anas,  superior  profunda.  MuSGUla'rOS, 
to  radial  side  forearm.  Sirrerficia'l.S  VO'ls,  just  as  artery  about 
to  wind  around  the  carpus—  to  muscles  in  ball  of  thumb  ;  anas. 
with  ulnar  forming  "  superficial  palmar  arch."  Ant.'riorcarpa'.i3, 
to  wrist;  anas,  anterior  carpalis  of  ulnar.  Poste'ri  r  Carp-'li:,  to 
wrist ;  anas,  posterior  carpalis  of  ulnar,  anterior  interosseous, 
and  posterior  perforating,  of  deep  palmar  arch  as  2  dorsal 
interosseous  branches.  MotaCTpi'lis,  (ist  dorsal  interosseous) 
supplies  adjoining  sides  index  and  middle  fingers.  LcnaleS 
PO  'lids,  (2)  along  dorsum  of  thumb.  D.rsa'llS  in'd  cis,  radial 
side  back  of  index.  Prin'cepS  pol'.icis,  beginning  palmer  arch  to 
sides  of  palmar  aspect  of  thumb.  BadL'liS  iu'dicis,  palmar  arch 
to  radial  side  index.  Perforan'  es,  (3),  to  inosculate  with  3  dor- 
sal interosseous.  Palma'reS  intero/ses,  (3  or  4),  from  arch  to 
anas,  at  finger-clefts  with  digital  branches  of  superficial 
arch. 

ULNA'EIS:  (8  brs.)  little  below  bend  of  elbow— along  radial 
Side  flexor  carpi  ulnaris  to  palm  of  hand,  forming  "superficial 


UPPER  EXTREMITY 


palmar  arch"  with  superficialis  volae.  Ante'rior  ulna'ris  recnr'rens, 
just  below  elbow-joint—up  and  inwards  between  brachialis 
anticus  and  pronator  radii  teres,  supplying  these ;  anas. 
anastomotica  magna,  and  inferior  profunda.  Po:te'rlOP  fclns/riS 
70Cur'rea3,  just  below  preceding — back  and  inwards  beneath 
flexor  sublimis  up  to  internal  condyle  humerus,  supplying 
joint  and  neighboring  muscles;  anas,  inferior  profunda, 
anastomotica  magna,  interosseous  recurrent.  IntWOS'sea,  short 
trunk  below  tuberosity  radius — backwards  to  interosseous 
membrane,  dividing  into:  INTEKOS'SEA  ANTE'RIOR,  passing 
down  forearm  on  interosseous  membrane,  piercing  membrane 
at  superior  border  pronator  quadratus  to  descend  to  back  of 
wrist,  supplying  nutrient  (to  radial  and  ulnar  arteries)  and 
muscular  branches  ;  gives  off  median  branch,  accompanied 
by  do  nerve.  Anas,  posterior  carpal  of  radial  and  ulnar. 
INTEROS'SEA  POSTE'RIOR,  down  back  forearm,  between  deep 
and  superficial  muscular  layers,  to  wrist,  supplying  these 
muscles;  anas,  as  preceding.  Posterior interos'sea recur*renst 
near  its  origin  to  interval  between  olecranon  and  external 
eondyle,  beneath  supinator  bre  vis  ;  anas,  superior  profunda, 
posterior  ulnar  recurrent.  HuBCUla'reB,  to  muscles  of  ulnar  side 
of  forearm.  Carpa'liS  ante'liflP,  beneath  flexor  profundus,  anas. 
anterior  carpal  of  radial.  Posterior  Carpa'liS,  above  pisiform 
tone,  beneath  flexor  carpi  ulnaris,  giving  small  branch  to  in- 
•sculate  with  posterior  carpal  of  radial,  forming  "posterior 
carpal  arch  " ;  continued  along  5th  metacarpus,  forming  its 
dorsal  branch.  Commu'niCttll,  from  commencement  palmar  arch, 
deeply  inwards,  anas,  with  radial  forming  "deep  palmar 
arch.'*  Digita'loi,  (4)  from  convexity  of  superficial  palmar 
arch,  supplying  ulnar  side  4th  and  adjoining  sides  3d,  ad  and 
xst  fingers. 

__ 
VEINS. 

Ulna'ris  ante'riOf,  from  anterior  carpus  and  ulnar  side  hand, 
up  along  ulnar  side  forearm  to  elbow-joint,  to  form  basilica 
Communicates  with  median  and  posterior  ulnar. 

Ulna'rs  posto'rlor,  pesterior  ulnar  border  hand  and  vein  of 
little  finger  (v.salvatel'la)— units*  with  preceding  just  below 
elbow-joint. 

Basll'ica,  coalescence  of  anterior  and  posterior  ulnares; 
receives  median-basilic  at  elbow,  ascends  inner  side  arm  to 
vense  comites  of  brachial  artery,  or  axillary  vein. 

Eai'a/lis,  dorsum  thumb,  radial  side  index  and  hand— at 
bend  elbow  receives  median-cephalic  to  become  the  cephalic. 


VEINS.  23 

Csphal'ica  up  between  deltoid  and  pectoralis  major  to 
axillary  veins 

Ifc'dia:  palmar  surface  of  hand  and  middle  of  forearm 
(communicates  with  ulnar  and  radial),  to  median-cephalic  and 
median-basilic  at  elbow. 

Oephal'ica  mo'dla :  obliquely  outwards  from  bend  elbow,  be- 
tween supinator  longus  and  biceps ;  empties  into  cephalic  as  a 
formative  branch. 

Basil'ica  me'lia:  obliquely  inwards  behind  biceps  and  pro- 
nator  radii  teres  ;  empties  into  basilic  as  formative  branch. 

The  following  are  the   deep   veins,  and  accompany  their 
respective    arteries   as   ve'nce   cont'itest   intercommunicating 
with  each  other,  and  the  superficial  veins,  frequently. 
,  (2)  empty  into  the  superficial  palmar. 
SUporflcialeS,  (2)  empty  into  ulnar  and  radial. 
a'res  proftin'da,  empty  into  radial  venae  comites. 
Xnteroa'.OB,  (2)   accompany  the  anterior  and  posterior  in- 
terosseous    arteries,  commencing  at    the  wrist,    terminating 
in  venae  comites  of  the  ulnar. 

Cca'ites  rad.a'iii,  form,  with  the  ulnar,  the  comites  of 
brachial. 

Comi';03Ulna'ris,  with  the  radial,  form  comites  of  brachial. 
Con'1.03   brach.a'liS,    receiving  veins  corresponding  to  the 
branches  of  the  brachial  artery,  empty  into  the  axillary  vein. 
Alilla'rfa,  is  the  continuation  of  the  basilic.    Commences  at 
lower  border  of  the  axillary  space ;  receives  veins  correspond- 
ing to  branches  of  its  artery,  and  terminates  in  the  subclavian 
at  outer  border  ist  rib.    [Valves  at  inferior  border  subscapu- 
laris,  terminations  of  vena  subseapularis  and  vena  cephalica.] 
Sub:la'via,  continuation  of  axillary,  emptying  into  vena  in- 
nominata  at  right  sterno-clavicular  articulation.    Separated 
from  its  artery  by  scalenus  anticus  muscle  and  phrenic  nerve. 
Receives  external  and  anterior  jugulars,  branch  from  cepha- 
lic, and  internal  jugular.    [Valves  just  external  to  entrance  of 
external  jugular,  or  about  i  inch  from  its  termination.] 

NERVES. 

PLSX'TJS  BBACHIA'LIS!  formed  by  anterior  roots ^.lower  cer- 
vical and  ist  dorsal  nerves.  5th  and  6th  cervical  unite,  then 
are  joined  by  yth  to  form  upper  trunk.  8th  cervical  and  ist 
dorsal  unite  to  form  lower  trunk.  Both  trunks  accompany  the 
subclavian  artery  to  the  axilla,  lying  upon  its  outer  side.  Op- 
posite clavicle,  each  of  the  trunks  gives  off  a  fasciculus, 
which,  uniting,  form  a  third  trunk ;  in  the  centre  of  the 


«4  UPPER  EXTREMITY. 

axilla  the  original  upper  cord  lies  to  the  outside  of  the  artery  ; 
the  original  lower  cord  to  the  inside;  the  cord  formed  from 
fascicular  union,  posteriorly.    The   plexus  lies  between   the 
anterior  and  middle  scaleni,  beneath  the  clavicle  upon  ist  ser- 
ration of  the  serratus  magnus  and  the   subscapular  muscles. 
(Has  4  brs.  above,  9  below  the  clavicle.)    Receives  communi- 
cating branches  from  cervical  plexus,  phrenic,  inferior  cervi- 
cal, sympathetic  ganglia.    Goamu'nicans,  5th  cervical  to  phrenic 
on    scalenus    anticus.      Husc'ila'rcs,    to    longus    colli,   scaleni, 
rhomboidei  and  subclavius.    Poste'lior  thorac'folS,  from  5th  and 
6th   cervical    to  serratus   magnus.      Passes    behind    brachial 
plexus.    Supra-SCaptlla'rifl,  from    "outer  cord"  obliquely  out- 
wards beneath   trapezius,    to    supra-spinous    fossa    through 
supra-scapular  notch,  here  giving  2  branches  tosupra-spinatus 
muscle   and   i   to  joint ;  in  infra-spinous  fossa,  2  branches  to 
muscle,  x  to  joint;  all  of  these  are  given  off  ABOVE  the  clavi- 
cle.   Those  BELOW  the  clavicle  are :  Exter'nus  anto'rior  thorac'icus, 
"outer  cord'*  inwardly  across  axillary  vessels   to  pectoralis 
major.    Inter'nufl  anto'rior  thorac'icUl,  "inner  cord"  passes  up  be- 
tween  axillary   artery   and  vein  (sometimes  perforating  the 
vein}  to  pectorales  major  and  minor.    Subscapula'rcs,  (3)  "pos- 
terior cord"  the  upper  to  subscapular  muscles  ;  the  longer  to 
latissimus  dorsi ;  the  lower  to  teres  major.     CiTCtUHflex'tlB,  "pos- 
terior  cord",  down  behind  axillary  vessels  to  lower  border 
subscapularis,    dividing  into  upper  branch    winding  _  round 
neck  of  humerus,  supplying  deltoideus  and  integument;  Joiu*r 
branch  to  teres  minor,  deltoideus  and  integument  over  pos» 
terior  surface  deltoid.    Articula'ris,  given  off  before  division, 
to  joint.    Uas'CUlfl-cuta'nOM,  continuation  of  outer  cord,  perfo* 
rates  coraco-brachialis,  obliquely   outwards  between  bicepa 
and  brachialis  anticus  to  these  muscles,  integument  to  elbow, 
and  to  the  joint.    Anterior  branch,    down   radial   border  oi 
forearm  from  elbow,  to  wrist,  supplying  integument  to  ball  oi 
thumb;  communicates  with  radial.     Posterior  branch,  given 
of  middle  of  forearm,  supplies  integument  to  wrist,  on  radial 
side;  communicates  with  radial  and  external  cutaneous.    Ifl« 
ter'E'lB  CUta'aeUB,  "inner  cord",   down  in  company  with  bra- 
chial   artery,  becoming    cutaneous  at  middle   of  arm,   then 
dividing  into  Anterior  branch,  supplying  integument  of  ulnai 
side  of  arm  to  wrist,  communicating  with  branch  from  ulnar 
posterior  branch  down,  on  inner  side  of  basilic  vein,  over  inter 
nal  condyle,   on  posterior    ulnar    side  of   forearm  to  wrist 
communicating  at  wrist  with  dorsal  branch  of  ulnar;  at  elbow 
with  lesser  internal  cutaneous.     Cuta'neuS  mi'nor  inter'nus,  fron 


NERVES.  25 

"inner  cord"  to  integument  inner  side  of  arm.  Me'diUS,,  (4 
branches)  arises  by  2  roots,  one  from  "  outer"  and  one  from 
"inner"  cord  ;  at  first  lies  to  outer  side  of  the  artery,  crosses 
it  at  middle  of  arm  ;  in  forearm  runs  between  the  2  heads  of 
the  pronator  radii  teres,  beneath  flexor  sublimis  till  near  an- 
nular ligament,  when  it  lies  between  flexor  sublimis  and  flexor 
carpi  radialis  ;  it  passes  beneath  annular  ligament  to  hand. 
(No  branches  in  the  arm.)  Muscula'res,  from  near  elbow,  to 
all  forearm  muscles  save  flexor  carpi  ulnaris.  Ante'rior  inter- 
os'seus,  follows  course  of  the  artery,  to  flexor  profundus 
digitorum,  flexor  longus  pollicis,  and  pronator  quadratus. 
Cuta'neus  falnta'ris,  crosses  annular  ligament,  the  outer 
branch  supplying  the  thumb-region  ;  the  inner  branch,  the 
palmar.  Digita'les,  (5)  two  go  to  thumb,  the  3d  to  radial 
side  of  index;  the  4th  divides  to  supply  adjacent  sides  of  index 
and  middle;  the  sth  the  adjacent  sides  of  middle  and  ring 
fingers,  communicating  with  branches  from  ulnar.  Ulna'ris, 
(7  brs.) ;  continuation  of  "inner  cord",  down  ulnar  side  of 
arm  and  forearm  (over  the  back  of  inner  humeral  condyle) 
upon  flexor  profundus  digitorum,  having  ulnar  artery  exter- 
nally, crosses  annular  ligament  at  outer  side  of  pisiform  bone, 
dividing  into  superficial  and  deep  palmar  branches.  Articu- 
la'res,  to  elbow  joint.  Muscula'res,  one  to  flexor  carpi  ulna- 
ris, the  other  to  flexor  profundus  digitorum.  Both  arise  near 
elbow.  Cuta'neus,  arises  middle  forearm,  has  a  deep  and 
superficial  branch.  Dorsa'lis  cuta'neus,  arises  2  inches  above 
wrist,  passes  to  back  of  hand,  supplying  ulnar  side  of  wrist, 
inner  side  of  little  finger,  adjoining  sides  of  little  and  ring 
fingers.  Articula'rest  to  wrist.  Palma'ris  superficial  Us, 
supplies  palmaris  brevis,  and  integument  inner  side  of  hand, 
ulnar  side  of  the  little  and  adjoining  sides  of  the  little  and  ring 
fingers.  Palma'ris  profun'dus,  follows  course  of  "  deep 
palmar  arch",  supplying  muscles  of  interosseous  spaces, 
lumbricales,  adductor  and  flexor  brevis  pollicis.  Ifas'ClllO-Spira'liS 
(4  brs.;  largest  br.  of  plexus)  continuation  of  "posterior 
cord";  winds  around  the  humerus  in  spiral  groove,  etc.,  to 
front  of  external  condyle,  then  divides  into  radial  and  inter- 
osseous.  Muscula'rest  to  triceps,  anconeus,  supinator  lon- 
gus, extensor  carpi  radialis  longior,  and  brachialis  anticus. 
Cuta'nei^  (3),  internal  branches  supply  integument  of  back  of 
arm  down  to  olecranon  :  external  branches  perforate  external 
kead  of  triceps,  supplying  integument  lower  anterior  half  of 
arm,  the  lower  branch  running  down  radial  side  of  forearm 
(posteriorly)  to  wrist,  supplying  contiguous  integument.  Ra- 


26  BODY. 

dia'lis,  down  by  outer  side  of  radial  artery,  just  concealed  by 
supinator  longus  till  within  3  inches  of  wrist,  where  pierces 
deep  fascia  of  outer  side  forearm  j  divides  to  supply  radial 
side  of  ball  of  thumb,  (communicating  with  external  cutaneous 
nerve),  and  on  back  of  hand  forms  an  arch  with  ulnar,  giving 
off  4  digital  nerves  J  the  ist  to  ulnar  side  of  thumb  j  the  ad  to 
radial  side  of  index  ;  the  3d,  adjoining  sides  of  index  and  mid- 
dle; the  4th,  adjoining  sides  of  middle  and  ring  fingers. 
Interos'seus  posterior,  pierces  supinator  brevis,  winding  to 
back  of  forearm,  passing  down  to  wrist,  there  having  gangli- 
onic  enlargement.  Supplies  carpus,  and  all  muscles  on  back 
of  forearm  except  anconeus,  supinator  longus  and  extensor 
carpi  radialis  longior. 

o . 

BOD  Y. 

MUSCLES. 

(l)   BACK,  FIRST  LAYER,   2. 

Trape'ziUS!  inner  3d  superior  curved  occipital  line,  liga- 
mentum  nuchse,  spinous  processes  of  jth  cervical  and  all  the 
dorsal  vertebrae— posterior  border  clavicle,  superior  margin 
acromian  process  and  superior  border  spine  of  scapula.  [Spi- 
nal accessory,  cervical  plexus.] 

Latis'iiULUS  dor'si:  aponeurosis  from  spinal  processes  6  lower 
dorsal,  all  lumbar  and  sacral  vertebrae,  external  lip  iliac  crest 
— twisting  upon  itself  so  as  to  be  inserted  into  bicipital  groove 
ofhumerus.  [Subscapular.] 

(2)  BACK,   SECOND  LAYER,   3. 

Leva'tor  an'guli  SCap'vtla  :  transverse  processes  of  3  or  4  supe- 
rior cervical  vertebrae — posterior  border  scapula,  [sth  cervi- 
cal, cervical  plexus.] 

Ehomboide'US  mi'nor :  ligamentum  nucha?,  spinal  processes  jth 
cervical  and  ist  dorsal  vertebras— down-  and  outwards  to  root 
scapular  spine.  [$th  cervical.] 

Bhomboide'uS  ma'jor  :  spinal  processes  superior  dorsal  vete- 
bras — tendinous  arch  along  vertebral  border  scapula.  [5th 
cervical.] 

(3)  BACK,  THIRD   LAYER,    4. 

Serra'tttS  pOSti'CUS  SUpe'rior:  ligamentum  nuchae,  spinal  proces- 
ses jth  cervical  and  2  or  3  superior  dorsal  vertebrae— superior 
border  ad,  3d,  4th,  5th  ribs.  [Posterior  external  brs.  cervical.] 

Serra'tus  pOSti'CUS  infe'rior  :  spinal  processes  nth  and  i2th  dor- 
sal, ist,  2d  and  3d  lumbar  vertebras — up  and  out  to  inferio 
border  4  inferior  ribs.  [External  branches  dorsal.] 


MUSCLES.  97 

Sple'niilS  :  ligamentum  nuchae,  spinal  processes  yth  cervical 
and  6  superior  dorsal  vertebrae — capitis,  into  mastoid  process 
and  occiput;  colli,  transverse  processes  3  or  4  superior  cervi- 
cal vertebrae.  [External  posterior  branches  cervical.] 

(4)  BACK,  FOURTH  LAYER,  SACRAL  AND  LUMBAR  REGION,  I. 

Erec'tor  Spi'lffl :  sacro-iliac  groove,  lumbo-sacral  tendon,  iliac 
crest,  transverse  processes  sacrum--sacro-lumbalis,  longissi- 
mus  dorsi.  [External  posterior  branches  lumbar.] 

(5)   BACK,    FOURTH   LAYER,    DORSAL  AND  CERVICAL  REGION,   TO. 

Sa'cro-hmba'liS  :  (see  above)— angles  inferior  ribs.    [Dorsal.] 

AccesSOiiilS  ;  angles  6  lower — angles  6  superior  ribs.  [Dor- 
sal.] 

Cervica'liS  ascen'dens  I  4  or  5  superior  ribs — transverse  pro- 
cesses 4t.h,  5th,  6th  cervical  vertebrae.  [Cervical.] 

Longis'simus  dor'si  I  see  erector  spinae,  of  which  it  is  the  lar- 
ger portion  ;  inserted  (lu;;:bar  region)  into  transverse  proces- 
ses lumbar  vertebras;  dorsal,  t.ps  transverse  processes  of  all 
vertebrae,  and  7  to  n  ribs,  between  their  tubercles  and 
angles.  [Lumbar,  dorsal.] 

Transversa'liS  COl'li:  transverse  processes,  3d,  4th,  5th,  6th 
dorsal  — transverse  processes  5  inferior  cervical  vertebrae. 
[Cervical  branches.] 

Tradie'lO-mastoido'us .'  transverse  processes  3d,  4th,  5th,  6th 
dorsal,  and  articular  processes  3  or  4  inferior  cervical  verte- 
brae— posterior  margin  mastoid  process.  [Cervical  branches.] 

Spina'llS  dor'si :  spinal  processes  ist,  2d  lumbar  and  nth  and 
X2th  dorsal  vertebrae — spinal  processes  of  dorsal  vertebra. 
[Dorsal  branches.] 

Spina'liS  cervi'cis:  spinal  processes  5th,  6th  cervical  (ist, 
ad  dorsal)  vertebrae — spinal  process  axis  (sometimes  3d  and  4th 
cervical.)  [Cervical  branches.] 

Complex'US :  transverse  processes  yth  cervical  and  3  superior 
dorsal  vertebrae,  articular  processes  4th,  5th,  6ih  cervical — 
between  superior  and  inferior  curved  occipital  lines.  [Cervi- 
cal branches,  sub-occipital,  great  occipital.] 

Biven'ter  cervi'cis :  2  or  4  tendons  from  as  many  superior 
dorsal  vertebrae — superior  curved  occipital  line,  inside  of  com* 
plexus  [Cervical  branches.] 

(6)   BACK,    FIFTH   LAYER,    8. 

Somispina'lis  dor'si:  transverse  processes  of  vertebrae  between 
Xith  and  5th  dorsal— spinal  processes  of  6th  and  jth  cervical 
and  4  superior  dorsal  vertebrae.  [Dorsal  branches.] 

Semispina'liS  COl'li:  transverse  processes  4  superior  dorsal  and 
articular  processes  4  inferior  cervical  vertebrae — spinal  pro- 
cesses ad,  3d,  4th,  5th  cervical.  [Cervical  branches.] 


S8  BODY. 

MnltifidttS  spi'nse :  fills  groove  on  either  side  spinal  proces- 
ses back  part  sacrum,  articular  processes  in  lumbar  and 
cervical  region,  transverse  processes  in  dorsal  region — spinal 
processes  and  lamina?  of  the  4  vertebrae  above.  [Posterior  spi- 
nal branches  ] 

Rotato'reS  S^i'nas;  (n)  upper  and  back  part  transverse  pro- 
cesses of  dorsal  vertebrae— inferior  border  and  outer  surface 
of  laminae  of  vertebras  above.  [Dorsal  branches.] 

Supra-spina'les :  on  spinal  processes  of  cervical  vertebrae. 
[Cervical  branches.] 

Inter-spina'les :  in  pairs  between  spinal  processes  of  adjacent 
vertebrae;  6  cervical,  3  dorsal  (ist  to  4th,  and  nth  to  i2th),  4 
lumbar.  [Spinal  branches.] 

Ezten'SOr  Coccy'giS  :  last  bone  sacrum— inferior  part  coccyx, 
lying  on  posterior  surface. 

Inter-transversa'les :  7  cervical,  12  dorsal,  4  lumbar,  lying 
between  transverse  processes.  [Spinal  branches.] 

(7)  ABDOMINAL   REGION  6. 

OUi'qOTS  abdom'iaiS  exter'nus  :  8  cogitations  from  inferior  bor- 
ders 8  lower  ribs — down  to  anterior  ^  outer  iliac  crest,  pubic 
spine  and  symphysis,  linea  alba.  Poupart's  ligament  formed  by 
its  aponeurosis.  [Inferior  intercostal,  ilio-hypogastric,  ilio- 
inguinal  nerves  supply  this  and  the  5  following  muscles.] 

Obl/qwiS  iater'nss:  outer  y2  Poupart's  ligament,  anterior^ 
middle  lip  iliac  crest,  lumbar  fascia — pectineal  line,  linea  alba, 
pubic  crest,  inferior  edges  cartilages  of  4  inferior  ribs. 

Transversals:  outer  yz  Poupart's,  anterior  %  internal  lip 
ilium,  internal  surfaces  cartilages  of  6  inferior  ribs,  aponeurosis 
from  spinal  and  transverse  processes  lumbar  vertebrae— pubic 
crest  (forming  with  above  "conjoined  tendon"),  lineae  ilio-pec- 
tinea  and  alba. 

EeC'tUS  abdom'inis:  pubic  crest  and  symphysis— cartilages 
$th,  6th,  7th  ribs.  (In  sheath  formed  by  internal  oblique  and 
transversalis  aponeuroses.) 

Pyram'.dall- :   pubes — linea  alba  midway  to  umbili'cus. 

Quadra'tttS  Imnbo'rum :  posterior  4th  iliac  crest,  ilio-lumbar 
ligament — transverse  processes  3d,  4th,  5th  lumbar  vertebrae 
.  and  last  rib. 

(8)  THORACIC   REGION  5. 

InterCOSta'leS  SXter'ail  (n)  outer  lip  of  groove  in  inferior  bor- 
ders of  ribs — down  and  forwards  to  superior  border  rib  below. 
[Intercostal.] 

Intercosta'les  inter'ni:  (n)  inner  lip  of  groove — down  and 
backwards  to  rib  below.  [Intercostal.] 


MUSCLES— ARTERIES.  2p 

InfracostaleS :  inferior  surface  of  one  rib — internal  surface 
ist,  2d  or  3d  lib  below.  [Intercostal.] 

Tr.angula'r.S  Ster'ni!  side  of  gladi'olus,  internal  surface  ensi- 
form  appendix,  cartilage  of  3  or  4  lower  true  ribs— cartilages 
of  2d,  3d,  4th,  sth  ribs.  [Intercostal.] 

Levato'res  COSta'nna:  (12)  transverse  processes  dorsal  verte- 
brae— superior  border  rib  below,  near  angle.  [Intercostal.] 

(9)  DIAPHRAGMATIC   REGION   I. 

Diaphrag'ma :  internal  surfaces  6  or  7  lower  ribs,  ligamenta 
arcuata,  crurcs  from  2d,  3d,  4th  lumbar  vertebrae,  ensiform 
cartilage — converge  forming  common  central  tendon.  Aortic 
opening  for  aorta,  vena  azygos  major,  thoracic  duct ;  cesojt'ha.- 
geal>  oesophagus  and  pneumogastric  nerves;  vena  cava. 
for  inferior  vena  cava;  right  crus  transmits  sympathetic  and 
greater  and  lesser  splanchnics;  left  crus,  vena  azygos  minor 
and  splanchnics.  [Phrenic.] 

(lo)   PERINAEAL    REGION  8. 

SpMnc'ter  a'ni :  tip  of  coccyx  and  fascia  in  front  — common 
central  perinaeal  tendon.  [Hemorrhoidal  br:m<_h  4th  sacral.] 

Sphinc'ter  inter'nUS  :  muscular  ring  (Y2  inch  wide),  i  inch 
from  anus,  surrounding  rectum. 

Accelerator  uri'ns  I  central  perineal  tendon  and  raphe — 
covers  bulb  corpus  cavernosum,  and  spongiosum,  and  dorsal 
vessels. 

Erec'tor  pe'niS  :  internal  surface  tuber  ischii — sides  and  in- 
ferior surface  crus. 

Transversal:  perins'i:  internal  surface  ascending  ischic  ramus 
—  obliquely  for-  and  inwards  to  central  perinaeal  tendon. 

Lsva'tOf  a'ai:  inside  of  pubic  ramus  and  body,  ischic  spine, 
fascia  ^an^le  of  division  into  obturator  and  vesical) — central 
perinaeal  tendon,  rectum,  coccyx  ;  forms  floor  of  pelvic  cnvity. 

Compres'SCT  ure'tlirsi  pubic  ramus — surrounds  membranous 
portion. 

COGCygS'us:  ischic  spine  and  lesser  sacro-sciatic  ligament — 
side  of  coccyx  and  last  sacral  segment. 

(In  the  female  the  above  perinaeal  muscles  are  essentially 
the  same  ;  the  erec'tor  clitori'dis  takes  the  place  of  erector 
penis,  being  inserted  into  the  sides  of  the  ciitoris;  sphincter 
vagi'nce  represents  the  accelerator  urinae  ol  the  male, 
surrounding  the  vagina.) 


ARTERIES. 

AECH  OP  AQKTA:  (5   branches);  from  left?  ventricle,  oppo- 
site middle  of  sternum,  upwards  for  2  inches,  arching  back* 


30  BODY. 

wards  over  root  of  left  lung  (on  level  2d  dorsal  vertebra),  the 
* '  descending  portion,"  runs  down  on  the  left  side  of  zd  and 
3d  vertebrae,  there  becoming  thoracic  aorta.  In  front,  are  left 
pleura,  lung,  pneumogastric,  phrenic,  and  cardiac  nerves; 
behind,  trachea,  right  pulmonary  vessels  and  nerves,  root  of 
right  lung,  cardiac  plexus,  oesophagus,  thoracic  duct,  left 
recurrent  nerve.  Corona'ria  dex'tra .'  above  free  margin  right 
semilunar  valve,  between  pulmonary  artery  and  right  auricu- 
lar appendix;  runs  round  right  border  of  heart  to  posterior 
interventricular  groove,  there  dividing  into  2  branches,  supply- 
ing right  heart;  anas,  at  apex  with  left  coronary.  Ccrona'ril 
sin'istra  I  (smaller)  above  left  semilunar  valve,  passes  forwards 
between  left  auricular  appendix  and  pulmonary  artery  to 
anterior  interventricular  groove,  dividing  into  two  branches, 
supplying  left  side  of  heart.  Innomina'ta  I  commencement  trans- 
verse portion  of  arch,  ascends  obliquely  up  to  right  sterno- 
clavicular  articulation,  dividing  into  common  carotid  and 

subclavian.  Caro'tis  commu'nis  sin'istra  and  Subcla'via  sin'istra :  (see 
pages  6  and  19.) 

AOB'TA  TEOEAC'ICA:  (see  arch)  5  branches.  Terminates  at 
aortic  opening  in  diaphragm  as  "abdominal  aorta,"  there 
lying  upon  front  ofvetebral  bodies.  Pericardi'acs  :  to  pericar- 
dium, BroncMa'les:  (3  generally)  to  the  left  bronchus.  (Eseph- 
age'ffl  I  (4  or  5)  front  of  aorta,  obliquely  down  to  oesophagus, 
anas,  with  inferior  thyroid,  gastric  and  phrenic  Uediastina'leS 
p:sterio'res;  glands  and  areolar  tissue  therein.  InterCOStalos  :  (;o 
pairs)  right  longer  than  left ;  pass  out  to  do  spaces,  there  di- 
viding into  anterior  branches  ascending  to  inferior  border 
rib  above,  the  smaller  branch  of  it  on  the  superior  border  rib 
below,  running  towards  sternum,  anas,  with  internal  mam- 
mary, thoracic  branches  of  axillary,  superior  intercostal, 
epigastric,  phrenic,  lumbar,  etc.  Posterior  branch  passes 
backwards,  supplying  vertebrae,  cord,  and  muscles  of  back, 
(ist  space  supplied  by  superior  intercostal  of  subclavian.) 

AOB'TA  ABDOM'HTIS :  (9  brs.);  from  aortic  opening  of  dia- 
phragm, in  front  last  dorsal  vertebrae,  terminates  on  body  4th 
lumbar,  in  the  "common  iliacs."  Phren'ica :  (2)  obliquely 
outwards  to  supply  diaphragm,  inferior  vena  cava,  oesopha- 
gus and  supra-renal  capsule;  anas,  freely.  Cceli'aca '.  (axis 
Y2  inch  long)  horizontally  forwards,  dividing  into  CORONA'RIA 
VENTRIC'ULI  (gastric),  which  passes  round  lesser  curvature 
stomach  from  cardiac  end  to  pylorus,  there  inosc.  with 
hepatic.  HEPAT'ICA,  to  the  transverse  fissure  of  liver  to  sup, 
ply  right  and  left  lobes,  giving  oSfyltfric  branch  to  stomach, 


ARTERIES.  31 

running  from  right  to  left ;  gas'tro-duodena'lis  that  supplies 
greater  curve  of  stomach  (gas'tro-epiplo'ica  dex'tra,  which 
inosc.  with  gas'tro-epiplo'ica  sin'istra  of  splenic),  pancreas  and 
duode'num  (pancreat'ico-duodena'lis,  which  inosc.  with  duo- 
denal branch  of  superior  mesenteric);  cys'tica,  small  branch 
to  gall  bladder.  SPLEN'ICA,  horizontally  left  to  spleen  \pan- 
creat'icce  (mag'na  and  par'vce)  small  branches  to  pancreas  ; 
va'sa  bre'via,  5  to  7  small  branches  to  cardiac  end  of  stomach  ; 
gas'tro-epiplo'ica  sin'istra,  around  greater  curve  stomach  from 
left  to  right,  anas,  gas'tro-epiplo'ica  dex'tra.  Supra-rena'leS  ; 
obliquely  up-  and  outwards  to  supra-renal  capsules.  MsSSLtSf'- 
icasupe'licr  :  J£  inch  below  coelic  axis,  to  the  intestines.  Infe'- 
rior  pancreat'ico-duodena'lis  t  up  to  head  pancreas  and  lower 
^  duode'num,  anas,  with  pacreat'ico-duodena'iis  of  hepatic. 
Va'sa  intesli'na  ten'uis,  12  to  15  looping  branches  to  jejunum 
and  ileum.  Il'io-col'ica,  down  right  obliquely,  to  ileum  and 
caecum.  Col'ica  dex'tra,  horizontally  to  right  to  ascending 
colon.  CoVica  me?diat  up  to  transverse  colon,  inosc.  colica 
dextra  and  colica  sinistra.  (Free  anastomosis  of  all  these  ves- 
sels.) Eenales :  sides  aorta  just  below  superior  mesenteric 
horizontally  outwards  to  each  kidney.  Spermat'iC83 :  slender 
vessels  supplying  testicles,  or  ovaries.  Mesinter'icainfe'rior  :  left 
side  aorta  2  inches  above  bifurcation,  to  sigmoid  flexure  of 
colon,  and  rectum.  Col'ica  sin'istra,  horizontally  to  left  to 
descending  colon.  Sigmoide'ce,  branches  passing  obliquely 
downwards  to  sigmoid  flexure.  Hoemorrhoida'lis  supe'rior, 
termination  of  inferior  mesenteric  supplying  superior  part  of 
rectum,  anas,  with  middle  haemorrhoidal  of  internal  iliac,  and 
inferior  haemorrhoidal  of  internal  pudic.  The  branches  of 
both  mesenteric  arteries  are  in  free  anastomosis.  Luffllia'leS !  4 
pairs  arising  from  back  aorta,  dividing,  near  transverse  pro- 
cesses into  abdominal  branches  (supplying  muscles,  and  anas. 
with  epigastric,  internal  mammary,  intercostal,  ilio-lumbarand 
circumflex  iliac  branches)  and  dorsal  branches  (supplying 
back  muscles,  etc.,  with  a  spinal  branch  to  meninges  and 
cord),  anas,  intercostal.  Sa'cra  me'diai  back  of  aorta  at  its 
bifurcation,  down  median  line  to  coccyx,  there  anas,  with 
lateral  sacral,  supplying  adjacent  parts. 

ILI'ACaJ  COMMU'NES:  from  bifurcation  of  aorta,  obliquely 
Out-  and  downwards  to  intervertebral  substance  between 
sacrum  and  last  lumbar,  there  dividing  into  internal  and  ex- 
ternal iliac  ;  each  are  about  2  inches  long.  Give  small  branches 
to  peritoneum,  ureters,  psoae,  etc.  The  left  is  the  larger. 

ILI'ACA  INTEB'NA:  (see  above);  i}£  inches  long,  dividing 


BODY. 


at  greater  sacro-sciatic  foramen  into  anterior  and  posterior 
trunks.  Branches  from  the  ANTERIOR  trunk  are  :  Vesica'liS 
SUpo'riori  part  of  foetal-hypogastric  that  remains  pervious,  to 
fundus  of  bladder,  and  vas  deferens.  Vesica'liS  me'dia!  base  of 
bladder  and  vesiculae  seminales.  Vesica'liS  infs'rior  :  base  blad- 
der, prostate,  and  vesiculae  seminales.  HsnorrJl.ida'liS  me'di}  I 
rectum,  anas,  with  haemorrhoidal  branch  of  inferior  mesen- 
teric  and  internal  pudic.  (Uterine:  to  neck,  and  ascends  to 
fundus,  giving  branch  to  ovary  and  tube,  etc.  Vaginal!  cor- 
responds to  inferior  vesicle,  supplying  vagina,  urethra,  etc.) 
Cbturato'ria  :  forwards  to  superior  border  obturator  foramen, 
escaping  there,  dividing  into  an  internal  (curving  round  inner 
border  foramen,  supplying  adjacent  muscles,  etc.,  anas,  with 
external  branch  and  internal  circumflex)  and  external  branch 
(round  outer  margin  foramen  supplying  adjacent  muscles). 
The  branches  inside  the  pelvis  are  iliac,  vesical  and^utzc;  the 
latter  anas,  with  epigastric.  Sometimes  rises  from  epigastric, 
then  liable  to  be  wounded  in  operation  for  hernia.  Plldi'd 
intsr'na;  terminal  branch;  supplies  external  generative  organs  ; 
out  of  pelvis  beneath  pyriformis  (great  sacro-sciatic  foramen), 
crosses  ischic  spine,  re-enters  pelvis,  through  lesser  sacro- 
sciatic  foramen,  ascends  ischic  ramus  up  to  pubes.  Htzmor- 
rhoida'les  znferio'res,  2  or  3  to  rectum,  etc.  Superficia'  Us 
ferinai'i,  to  scrotum  and  perinaeum.  Transver'sa,  germce'l. 
A.  corpo'ris  bulbo'si,  to  bulb  and  Cowper's  gland.  A.  corpo'ris 
caverndsi,  terminal  branch  running  forwards  in  this  struc- 
ture. Dorsa'lis  pe'nis,  forwards  to  glans.  Sciat'ica:  terminal 
branch  (see  lower  extremity.)  Branches  from  the  POSTERIOR 
trunk  are:  Glutffi'a  SUpe'rior:  (see  lower  extremity.)  Hifl-lumba'lis  \ 
divides  at  upper  part  iliac  fossa  into  lumbar  (to  psoas  and 
quaclratus  muscles,  branches  to  spinal  canal)  and  iliac 
branch  (to  iliacus  internus,  anas,  with  gluteal,  epigastric, 
etc.)  Sacra'leS  laterals:  :  (2)  superior  •,  enters  ist  or  2d  sacral 
foramen,  anas,  wuh  fellows  and  middle  sacral  ;  inferior,  de- 
scends on  sacrum,  anas,  over  coccyx  with  middle  sacral  and 
opposite  fellow. 

ILI'ACA  E2TEBUA  :  from  bifurcation  common  iliac  to  femoral 
arch.  Li.ie  drawn  from  left  of  umbili'cus  to  a  point  on  Pou- 
part's  ligament  midway  between  pubes  and  anterior  superior 
spinal  process  of  ilium,  indicates  its  course.  Epigas'tlica! 
few  lines  above  Poupart's,  up-  and  inwards  to  umbili'cus, 
there  anas,  with  internal  mammary  and  inferior  intercostal. 


iaires. 


,  sa. 

i'ica  cxtcrna'list  to  Qreraa-stcr,  Pubic  brancib,  Muscu- 
Circmailei'a  iTii:  origin  opposite  above  from  outs?  «ue 


VEINS.  33 

artery,  runs  obliquely  up-  and  outwards  on  iliac  crest,  su^ 
plying  adjacent  muscles,  and  anas,  with  gluteal,  epigastri^ 
and  lumbar  arteries. 


VEINS. 

Innomlna'tffl  ;  right  is  short  (1%  inches  long),  running  from 
sterno-cLivicular  articulation  to  join  left  innominate  at  infe- 
rior border  cartilage  of  ist  rib,  forming  vena  cava  superior. 
Is  external  to  artery,  and  receives  right  lymphatic  duct,  right 
vertebral,  ri^ht  internal  mammary,  right  inferior  thyroid  and 
ri^'it  superior  intercostal  veins.  Left  is  3  inches  long,  runs  ia 
front  of  the  three  large  arterial  branches  of  aorta  ;  receives 
corresponding  venous  branches  as  ri^ht.  Neither  have  valves, 

Uamma'ria  inter'aa  :  2  to  each  artery,  uniting  in  single  trunk, 
emptying  into  innominate. 

TJiyroide'l  info'rior  :  (sometimes  3  or  4)  from  thyroid  venout 
plexus,  empty. ng  into  right  and  left  innominate. 

Intsrcosta'les  Superio'res :  from  2  or  3  superior  intercostal 
spaces,  emptying  into  innominate.  Left  bronchial  emptiel 
into  left  intercostal. 

Vo'naca'va  SUpe'rior:  *%  to  3  inches  long,  formed  of  venz» 
innom.natae,  emptying  into  right  auncle;  receives  vena  azygos 
major,  and  pericardial  veins.  No  valves. 

Az'ygOS  ffia'jor :  opposite  ist  or  ad  lumbar  vertebra,  from 
right  lumbar  veins,  up  through  aortic  diaphragmatic  opening 
to  right  side  3d  dorsal  vertebra,  arching  over  root  right  lung, 
emptying  into  vena  cava.  Receives  the  jo  lower  right  inter- 
costal veins,  vena  azygos  minor,  several  oesophageal,  media*- 
tinal,  vertebral,  and  right  bronchial  veins.  Imperfect  valves, 
though  its  branches  have  complete  ones. 

Az'ygOS  ai'nor  irfe'rior :  lumbar  region  of  left  side  from  lun> 
bar  veins,  or  branches  of  renal,  through  left  crus  of  di- 
aphragm to  6th  or  7th  dorsal  vertebra,  there  crossing  to 
terminate  in  azygos  major.  Receives  4  or  5  lower  intercostal, 
and  some  oesophageal  and  mediastinal  veins. 

Az'ygOS  mi'nor  SUpe'rior :  from  branches  intercostal  and  azy- 
gos minor  inferior  veins ;  empties  into  one  of  the  other  azygos 
veins. 

Bronchia' ©S!  from  lungs;  the  right  terminating  in  azygo* 
major  ;  the  left  in  the  left  superior  intercostal. 

Spina'les  :  dorst-sjina'lis,  whole  length  of  back  of  spine, 
forming  network,  terminating  in  the  vertebral  (of  neck),  th« 
intercostal  (of  thorax),  lumbar  and  sacral  veins.  Longitndl 
na'les  swindles  anterio'res,  whole  length  vertebral  forameuj 


34  BODY. 

interior  surface  terminating  as  dorsi-spinal,  etc.  Longitudi* 
na'lss  spina'ies  posteridres,  whole  length  vertebral  foramen, 
posterior  surface,  terminating  in  dorsi-spinal.  V.  ba'sis  ver- 
tebra'rum,  from  bodies  of  vertebrae,  terminating  in  anterior 
longitudinal.  Medul'li-spina'les,  cover  cord,  between  pia 
and  arachnoid,  from  sacrum  to  occiput ;  anas,  freely  with 
those  contiguous.  No  valves  in  any  of  the  spinal  veins. 

Hi'aca  ©zter'na,inter'naand  commu'nis,  see  lower  extremity.  ^ 

Ve'na  ca'va  iufs'rior:  junction  of  the  2  common  iliacs,  up  on 
right  side  of  aorta,  terminating  in  lower  and  back  part  of 
right  auricle.  It  receives  :  the  lumbar  branches  (3  or  4  in  No.) 
from  muscles  and  integument  of  loins  ;  the  right  spermatic 
(the  left  emptying  into  left  renal),  both  having  valves ;  ova- 
rian, have  same  termination;  the  renal,  the  left  being  the 
longer;  the  right  supra-renal  (the  left  terminating  in  the  left 
renal,  or  phrenic);  the  right  fhrenics  (the  left  superior 
emptying  into  superior  intercostal  or  internal  mammary,  and 
the  inferior  into  the  left  renal);  the  hepatic,  3  branches  (no 
valves),  these  commencing  as  the  iw^ra-lobular  veins  (in  the 
centre  of  the  lobule),  forming  the  .y»<Mobular,  and  these  last 
finally  the  larger  hepatic  trunks. 

Ve'aa  por'ta  :  4  inches  long ;  no  valves  in  it  or  i*s  branches  ; 
formed  by  mesenter'ica  inferior,  (draining  rectum,  sigmoid 
flexure,  and  descending  colon ;  its  branches  inosc.  with  in- 
ternal iliac);  ntesenter'ica  supe'rior  (draining  small  intestines, 
caecum,  ascending  and  transverse  colon);  splen'icce  (5  or  6 
branches  from  spleen  ;  receiving  branches  of  va'sa  bre'via, 
left  gas'tro-epiplo'ica,  pancreat'ica  and  pancreat'ico-duodena'- 
lis  veins)  ;  gas'trica,  from  lesser  stomachic  curvature. 

Cardi'aCffl:  ve'na  cor'dis  •mag'na,  from  apex,  up  anterior 
interventricular  groove  to  base  ventricles,  curving  to  left  side 
to  back  part  of  heart,  emptying  into  coronary  sinus,  guarded 
by  2  valves;  receives  posterior  cardiac  and  left  cardiac  veins. 
Ve'na  cor'dis  me'dia,  (posterior  cardiac)  from  apex  up  poste- 
rior interventricular  groove,  terminating  in  coronary  sjnus, 
guarded  by  valve.  Ve'na  par'vce,  (anterior  veins),  3  or  4 
small  branches  from  anterior  surface  of  right  ventricle,  empty- 
ing into  lower  part  right  auricle.  Ve'na  thebefsii  drains  mus- 
cular substance,  opening  into  right  auricle. 

Pulmona'les  :  4  in  No.;  commence  in  capillary  network  upon 
bronchial  cells,  uniting  to  form  a  trunk  for  each  lobe,  the  one 
of  the  middle  lobe  of  the  right  lung  unites  with  the  one  from 
the  superior  lobe,  hence  a  veins  from  each  side.  No  valves; 
carry  arterial  blood; 


NERVES.  35 

NERVES. 

BEEVES  :  31  pairs,  viz.:  8  cervical,  12  dorsal,  5 
lumbar,  5  sacral,  i  coccygeal.  Each  have  an  anterior  and 
posterior  root,  hence  have  moto-sensor  functions. 

'Cervlca'les  I  (see  pages  15  and  16).  Dorsa'les  :  ist  from  be- 
tween ist  and  2d  dorsal  vertebrae,  the  last  from  between  i2th 
dorsal  and  ist  lumbar.  The  POSTERIOR  branches  have  external 
and  internal  branches.  The  cutaneous  branches  are  the  6 
upper  from  the  internal  branches,  the  6  lower  from  the  exter- 
nal branches.  These  nerves  supply  the  structures  of  the 
back.  ANTERIOR  branches  supply  walls  of  the  chest  and 
abdomen,  each  having  branches  from  the  sympathetic.  Su- 
ferio'res  Intercosta'les)  pass  forwards  with  the  arteries,  giving 
off  numerous  branches,  the  chief  being  the  lateral  cutaneous, 
which  have  anterior  and  posterior  branches.  The  ist  inter- 
costal has  no  lateral  branches;  the  2d  has  a  large  one  (the 
intercos'to-humera'lis,)  which  supplies  the  integument  of  up- 
per inner  half  of  arm.  Intercosta'les  inferio'res,  have  nearly 
the  same  course  as  the  superior,  supplying  the  anterior  cuta- 
neous nerves  to  abdomen,  and  having  lateral  branches. 

LumTjaleS  :  have  largest  roots  of  all  ;  have  anterior  and 
Posterior  branches  ;  the  latter  having  external  and  internal 
branches  ;  the  anterior  branches  uniting  to  form  the  lumbar 
plexus.  Supply  muscles  and  integument  in  their  region.  The 
anterior  branches  communicate  with  sympathetic.  Sacra'103 
and  Coccygea'les  :  (see  nerves  of  lower  extremity.) 


EXTREMITY. 

MUSCLES. 

(l)  ILIAC   REGION    3. 

Pso'aS  ttag'nSS  •  last  dorsal  and  all  lumbar  vertebrae  (trans- 
verse processes)  —  lesser  trochanter,  in  union  with  iliacus.  [An- 
terior branches  lumbar.] 

Pso'aS  par'vug  :  sides  of  bodies  last  dorsal  and  ist  lumbar 
vertebrae—  ilio-pectineal  eminence.  [Anterior  branches  lum- 
bar.] 

Ili'aCUSI  iliac  fossa,  crest  and  anterior  spinous  processes  of 
ilium,  base  sacrum  —  outer  side  tendon  psoas  magnus.  [Ante- 
rior crural.] 

(2)   ANTERIOR   FEMORAL  REGION  7. 

Ten'SOr  7agi'n»  fem'oriS  :  outer  crest  ilium,  anterior  superior 
Spinous  process  —  fascia  lata,  %  way  (laterally)  down  the  thigh. 
[Superior  gluteal.J 


36  LOWER    EXTREMITY. 


s;  (longest  muscle  of  body)  anterior  superior  spinal 
process  laum,  part  of  no.cii  ueiovv—  upper,  inner  side  of  tibia! 
shaft,  having  crossed  the  anterior  surface  of  the  thigh 
obliquely.  [Anterior  crural.] 

Qnad'r.cepS  exten'sor:  (vas'ti  inter'nus  and  exter'nus,  rec'tus 
and  crure'us);  the  recftus  from  anterior  inferior  spinal  pro- 
cess ilium  and  groove  above  acetabulum,  —  the  vets'  tus  exter'nus 
from  anterior  border  great  trochanter,  linea  aspera,—  the 
vas'tus  inter'nus  and  crure'us  from  inner  lip  of  linea  aspera  and 
nearly  all  internal,  anterior  and  external  surface  of  femur- 
shaft  —  into  patella.  [Anterior  crural.] 

Subcmre'US  :  lower  anterior  surface  of  femur  —  synovial 
pouch  behind  patella.  [Anterior  crural.] 

(3)    INTERNAL    FEMORAL  REGION   5. 

GracM'SI  inner  margin  rami  of  pubes  and  ischium  —  inner 
side  upper  part  tibia  above  insertion  semitendinosus  and 
beneath  sartorius.  [Obturator.] 

Psctins'US  I  Gimbernat's  ligament,  linea  ilio-pectinea  —  rough 
line  between  trochanter  minor  and  linea  aspera.  [Obturators 
and  anterior  crural.) 

£dduc'torlon't,US  :  front  of  pubes—  middle  sd  of  linea  aspera. 
[Obturators.] 

Adduc'tor  bre'vis:  descending  ramus  of  pubes  between 
gracihs  and  obiuiator--up"er  part  linea  aspera,  behind  pec- 
tineus.  [Obturators.] 

AddfcC'tor  xaag'm;  I  ramus  of  pubes  and  ischium,  and  tuber 
ischi,  —  from  great  trochanter  to  inner  condyle.  [obturator 
and  great  sciatic  ] 

(4)    GLUTEAL  REGION  9. 

Glntss'ttS  max'imtLS  :  superior  curved  line  of  ilium  down  to 
coccyx  and  sacro-sciat;c  ligaments  —  rough  line  between  great 
trochanter  and  linea  aspera.  [Inferior  gluteal  branch  sacral 
plexus] 

Gluts'US  me'dius:  between  superior  and  middle  iliac  curved 
lines,  crest,  fascia—  great  trochanter.  [Superior  gluteai.] 

Glnte'tH  mitt'  BW3  :  b-  tween  middle  and  inferior  curved  lines, 
margin  greut  sacro-sci.uic  notch  —  impression  anterior  border 
trochanter  major.  [Superior  gluteal.] 

Pyrlfor'mis  :  front  of  sacrum,  anterior  margin  great  sacro- 
sciatic  foramen  ami  anterior  surface*  great  sacro-sciatic  liga- 
ment, etc.  —  through  great  sacro-sciatic  foramen  to  superior 
border  great  trochanter.  [Sacral  plexus.] 

Obtnra'tor  inter'nus:  inner  margin  obturator  foramen,  pubic 
and  ischic  rami,  and  obturator  membrane  —  through  lesser 


MUsCLES.  37 

Sacro-sciatic  foramen  to  superior  bor    ,T  great  trcJchahter  in 
front  of  pyriformis.     [Sacral  plexus.] 

Gemol'ltti  Sups'rior  I  outer  surface  of  spine  of  ischium — hori- 
zontally outwards  to  superior  border  great  trochanter,  in 
company  with  obturator  intefnus.  [Sacral  plexus.] 

Cte»9i''ttB  i»f9'rieri  superior  outer  border  tuber  ischii — supe- 
rior border  great  trochanter  with  obturator  internus.  [Sacral 
plexus.] 

ObtealW  oster'nsi:  inner  side  obtufator  foramen,  pubic  and 
Ischic  rami,  internal  ^  of  external  surface  obturator  mem- 
brane—out- and  backwards  to  digital  fossa  of  femur.  [Obtu- 
rator ] 

ftuaira'tua  fem'orla:  outer  border  tuber  ischii— horizontally 
outwards  to  linea  quadrati  of  posterior  surface  of  great  trO- 
chanter.  [Sacral  plexus.] 

(5)   POSTERIOR   FEMORAL  REGION    3. 

Bi'COpS!  long  head  from  tuber  ischii,  short  head  from 
linea  aspera — outer  sidfe  head  fibula,  covering  external  lateral 
ligament.  Forms  outer  "  ham-string."  [Great  sciatic.] 

fiwni-tondinO'SttS  t  tuber  ischii  in  company  with  biceps,  and 
the  aponeurosis— tendon  (inner  side  popliteal  space)  curves 
round  ir.ternal  tibial  tuberosity  to  inner  surface  of  shaft  (ex- 
ternal nnd  beneath  sartorius.)  [Great  sciatic.] 

BsZoi-SisaBrano'WS  1  tuber  ischii,  above  and  external  to 
biceps  and  semi-tendinosus— back  of  tibial  tuberosity  in  3 
digitations,  beneath  internal  lateral  iigainent.  The  two  pre- 
ceding, with  this»  and  gralilis  and  sartorius,  form  inner 
"  hamstring."  [Great  sciatic.] 

(6)   ANTERIOR    TIBIO-FIBULAR   REGION   4. 

TibialiS  anti'CUS  :  outer  tibial  tuberosity  and  superior  ^ 
shaft,  external  surface — inner  under  surface  internal  cunei- 
form and  base  ist  metatarsus.  [Anterior  tibial.] 

Exten'SOT  pro'pril  pol'licis:  middle  anterior  surface  fibula 
and  intcrosseous  membrane — base  last  phalanx  great  toe. 
[Anterior  tibial.] 

Extea'SOT  loa'gns  digitO'nmi:  external  tuberosity  tibia,  upper 
^  anterior  surface  shaft  of  fibula,  interosseous  membrane— 3 
tendons  distributed  to  4  lesser  toes.  (Anterior  tibial.) 

PcrOHO'ES  tO't /US  I  part  of  above,  lo\ver  outer  fourth  fibula  . 
— base  sth  metatarsus.    [Anterior  tibial.] 

(7)   POSTERIOR    TIBIO-FIBULAR    REGION,    SUPERFICIAL   LAYER ,    3. 

Ga.trocne'mins :  2  heads,  one  from  each  femuric  condyle — 
unites  with  soleus  to  form  tendo  Achillis,  inserted  into  poste- 
rior surface  os  calcis.  '_Iuternal  popliteal.] 


38  LOWER    EXTREMITY. 


g;  oblique  line  tibia,  back  of  head  and  superior  por- 
tion fi!,ular  shaft  —  os  calcis.     [Internal  popliteal.] 

Planta'ris  S  outer  surface  external  femuric  condyle  and 
posterior  ligament  knee-joint—  os  calcis,  posterior  surface. 
Noted  for  long,  slim  tendon.  [Internal  popliteal.] 

(8)   POSTERIOR    TIBIO-FIBULAR    REGION,    DEEP   LAYER,    4. 

Poplits'US:  (forms  floor  popliteal  space)  depression  below 
tuberosity  of  external  femuric  condyle  —  inner  %  triangular 
space  above  oblique  line  on  posterior  surface  tibia.  [Inter- 
nal popliteal.] 

Flex'orlon'guspo'.li'cis;  lower  internal  %  fibular  shaft,  inter- 
osseous  membrane,  muscular  septum  and  fascia—  through 
groove  in  tibia,  astragalus,  calcis  to  base  last  phalanx  big  toe. 
[Posterior  tibial.j 

Flex'or  bn'gU3  digits'rvua;  posterior  surface  tibia  below  oblique 
line,  intermusoular  septum  —  behind  inner  malleolus,  calcic 
arch,  joined  by  tendon  flexor  accessorius,  divides  into  4  ten- 
dons which  pass  through  slits  in  the  tendons  of  flexor  brevis 
digitorum  to  be  inserted  into  bases  of  last  phalanges  of  the  4 
outer  toes.  [Posterior  tibial.] 

Titia'liS  Posti'CBJ  I  interosseous  membrane,  superior  %  pos- 
terior surface  tibial  shaft,  superior  %  fibula,  inner  surface  — 
behind  inner  malleolus,  beneath  calcaneo-scaphoid  articula- 
tion to  tuberosity  scaphoid  and  internal  cuneiform.  [Poste- 
rior tibial.] 

(9)    FIBULAR    REGION    2. 

Peronae'nS  lon'gUS  :  head,  and  upper,  outer  %  fibular  shaft, 
muscular  fascia.  and  septa  —  behind  external  malleolus,  through 
cuboid  groove  to  outer  side  base  ist  metatarsus.  [Musculo- 
cutaneous.] 

Peronffi'US  bre'viS  :  middle  %  outer  surface  fibular  shaft, 
muscular  septa  —  behind  external  malleolus  to  dorsal  surface 
base  5th  metatarsus.  [Musculo-cutaneous.] 

(lOj    FOOT,    DORSAL    REGION,    I. 

Exten'sor  brsViS  digiio'mia:  outer  side  os  calcis,  astragalo- 
calcanean  ligament,  anterior  annular  ligament  —  4  tendons,  the 
ist  into  ist  phalanx  of  great  toe,  the  rest  into  outer  sides  of 
tendons  of  long  extensor  to  zdt  3d  and  4th  toes.  [Anterior 
tibial.] 

(ll)   FOOT,   PLANTAR    REGION,    IST    LAYER,   3. 

Abdnc'tor  pol'licis!  inner  tuberosity  os  calcis,  internal  annu- 
lar ligament,  plantar  fascia  —  inner  side  base  ist  phalanx  great 
toe.  [Internal  plantar.] 

FlSX'or  bro'vis  digito'rum  :  internal  tuberosity  os  calcis,  plantar 


ARTERIES.  39 

fascia,  muscular  septa — 4  tendons,  sides  ad  phalanges  of  outer 
toes.     [Internal  plantar.] 

Abduc'tO?  min'imi  dig'iti:  outer  tuberosity  os  calcis,  plantar 
fascia,  muscular  septum — outer  side  base  ist  phalanx  little 
toe,  joins  tendon  of  short  flexor.  [External  plantar.] 

(12)  FOOT,    PLANTAR    REGION,    2D    LAYER,    2. 

Flex'or  acCQiSO'riuS  :  inner  head  from  inner  surface  OS  calcis 
and  calcaneo-scaphoid  ligament ;  outer  head,  inferior  surface 
os  calcis  and  plantar  ligament — tendon  flexor  longus  digito- 
rum.  [External  plantar.] 

Lwnbrica  les :  (4);  tendon  of  long  flexor — inner  sides  bases 
ofzd  phalanges  of  4  outer  toes.  [Internal  plantar  to  ist  and 
ad  ;  external  plantar  to  3d  and  4th.] 

(13)  FOOT,  PLANTAR  REGION,  30  LAYER,  4. 

Flex'OP  fcre'vis  pol'liciS :  internal  border  of  the  cuboid  and 
contiguous  surface  of  external  cuneiform,  tendon  of  tibialis 
posticus — outer  and  inner  sides  base  ist  phalanx  big  toe 
[Internal  plantar.] 

Addnc'tor  pollicisi  tarsal  extremity  of  ad,  3d  and  4th  meta- 
tarsi and  sheath  of  peroneus  longus— outer  side  base  ist 
phalanx  big  toe.  [External  plantar.] 

Flez'or  bre'vis  min'imi  dig'iti :  base  of  5th  metatarsus  and 
sheath  peroneus  longus — outer  side  base  ist  phalanx  little 
toe.  [External  plantar.] 

Trans  ver'SUS  ps'dis  I  under  surface  head  sth  metatarsus, 
transverse  ligament  of  metatarsus — outer  side  ist  phalanx  of 
big  toe.  [External  plantar.] 

(14)   FOOT,   PLANTAR    AND    DORSAL  INTEROSSEOUS    REGION,    7. 

Interos'sei  dcrsa'lOS :  (4);  bipenniform,  from  adjacent  sides 
of  metatarsi — bases  of  ist  phalanges,  outer  (except  the  ist)  side 
of  the  4  outer  toes.  Planta'rOSI  (3);  arise  from  the  shafts  of 
the  3d,  4th  and  sth  metatarsi,  inner  side — inner  sides  of  the 
bases  of  the  ist  phalanges  of  the  same  toes,  and  common  ex- 
tensor tendon.  [External  plantar.] 


ARTERIES. 

SCIATICA:  (5  branches):  larger  terminus  of  anterior  trunk 
of  internal  iliac  ;  out  through  lower  part  of  the  great  sacro- 
sciatic  foramen,  resting  on  pyriformis,  descending  between 
tuber  ischii  and  great  trochanter,  to  supply  muscles  of  the 
th;gh.  CoCCygea'llS  I  inwards,  piercing  great  sacro-sciatic  liga- 
ment, supplying  glutaeus  maximus  and  integument.  Glnts'8 

infcrio'res:  3  or  4  supplying  glutaeus   maximus.     Co'mes  ner'vi 
d'ici:    accompanying    great    sciatic  nerve,    and    finally 


40  LOWXR    EXTREMITY. 

jierces  it  and  is  lost  in  its  substance.  Huacnla'ros  !  to  back 
part  of  hip,  anas,  with  gluteal,  superficial  perforating,  exter« 
aal  and  internal  circumflex.  Articula'roS :  to  hip-joint  capsule. 

GLEUTJS'A  SJrS'BlOB:  largest  branch  of  internal  iliac  ;  out 
above  pyriformis,  dividing  into  deep  and  superficial  branches; 
supplies  iliacus,  obturator  interims,  pyriforra.  Superficial 
branch,  beneath  glutaeus  maximus,  supplying  it;  anas,  with 
posterior  branch  sacral.  Deep  branch,  between  glutaeus 
medius  and  glutaeus  minimus,  the  superior  division  anas,  at 
anterior  superior  spinous  process  of  ilium  with  circumflex 
iliac  and  external  circumflex;  the  inferior  division  goes  to 
great  trochanter,  anas,  with  external  circumflex.  Branches 
supply  all  muscles  in  this  region,  also  joint. 

FZMOEA'LIS  :  (7  branches);  from  Poupart's  ligament  to  open- 
ing in  adductor  magnus.  A  line  drawn  from  the  middle  of 
said  ligament  to  internal  femuric  condyle  lies  over  its  course. 
Vein  lies  on  inside;  anterior  crural  nerve  on  the  outside  of 
artery.  Suporflcialis  eplgas'trica ;  l/2  inch  below  Poupart's  liga- 
ment through  saphenous  opening  upwards  to  umbili'cus  in  the 
fascia  covering  the  external  oblique  abdominis  ;  anas,  deep 
epigastric  and  internal  mammary.  Superficia'.i:  C  rcunflex'aili'aca: 
arises  close  to  above,  outwards  to  iliac  crest,  supplying  glands 
fascia  and  integument,  anas,  circumflex  iliac,  gluteal,  external 
circumflex.  SupetflC  al.S  exter'na  pud/ca:  inner  side,  %  inch 
below  Poupart's  ligament,  pierces  fascia  lata,  crosses  sperma- 
tic cord,  supplies  integument  of  lower  part  of  abdomen,  penis, 
scrotum,  (or  labia)  ;  anas,  internal  pudic  branches.  Profun'da 
tster'na  pudi'ca:  passes  inwards  on  pectineus,  piercing  fascia  at 
pubes,  supplies  integument  of  perinaeum,  scrotum,  (or  labia)  \ 
anas,  superficial  perinseal.  Profun'da  fea'oris;  outer  and  back 
part,  i  to  2  inches  below  Poupart's  ligament,  passes  back  of 
artery  and  the  femoral  vein  to  inner  side  femur,  terminating 
in  adductor  magnus,  lower  3d,  anas,  with  popliteal  and  infe- 
rior perforating.  Circumflex'a  exter'na,  having  ascending, 
descending  and  transverse  branches,  supplying  muscles  in 
that  region,  and  anas,  with  gluteal,  circumflex  iliac,  superior 
articular  of  popliteal,  near  great  trochanter  with  sciatic, 
superior  perforating  and  internal  circumflex.  Circumflex1  a  in- 
ter'na,  inwards  to  joint,  supplying  contiguous  mnscles,  and 
head  of  femur;  anas,  with  obturator,  sciatic,  external  circum- 
flex and  superior  perforating.  Perforan'tes,  the  *'  superior," 
supplying  adductors  magnus  and  brevis,  biceps,  glutaeus 
maximus  and  anas,  with  sciatic,  internal  circumflex  and  mid- 
dle perforating;  "  middle"  on«  supplies  flexors  of  thigh  and 


ARTERIES.  41 

nutrient  artery,  anas,  with  its  fellows;  the  "  inferior"  sup- 
plies the  thigh  flexors,  anas,  with  its  fellows  and  terminal 
branch  of  profunda.  Muscala'WS :  2107  in  No  ,  supplying  sar- 
torius  and  vastus  internus.  Anastonwt'ic*  fflaj'fia  I  arises  just 
before  the  femoral  pierces  the  adductor  inagnus,  dividing  into 
superficial  branch,  accompanying  long  saphenous  nerve,  to 
supply  integument ;  deep  branch  descends  to  inner  side  of 
knee,  where  it  anas,  with  superior  internal  articular  and 
recurrent  of  anterior  tibial,  and  supplies  knee-joint  and  con- 
tiguous parts. 

POPLITJE'A;  (7  branches);  from  termination  of  femoral 
down  to  lower  border  of  pophteus  muscle,  dividing  into  an- 
terior and  posterior  tibial.  Nerve  and  vein  superficial  to 
artery.  MlLBCUla'reS  \  superior  (2  or  3),  supply  vastus  externus 
and  thigh  flexors;  anas,  inferior  perforating,  terminal  branches 
profunda.  Inferior  (2),  supply  gastrocnemius  heads  and 
plantaris.  Arise  opposite  knee-joint.  Csta'nei:  supply  integu- 
ment of  calf  of  leg.  ArtiCUla'tSS  SUpario'reS  :  internal^  running  in- 
wards over  femuric  condyles,  anas,  with  anastomotica  magna, 
inferior  internal  articular  and  superior  external  articular, 
supplying  vastus  internus  and  knee-joint.  Externalt  running 
circularly  outwards  above  femuric  condyles,  supplying  vastus 
externus,  knee-joint,  etc.;  anas,  with  external  circumflex, 
and  with  anastomotica  magna  forming  an  arch.  As'ygOS  irtiCB- 
la'rs  I  opposite  bend  of  joint,  piercing  posterior  ligament, 
supplies  ligaments,  synovial  membranes  and  joint.  Articnla'reS 
iaforio'res »  wind  round  tibial  head;  the  internal^  beneath  in- 
ternal lateral  ligament,  etc.,  to  front  and  inner  side  of  joint, 
supplying  tibial  head  and  joint.  The  external,  beneath  ex- 
ternal lateral  ligament,  etc.,  to  front  of  joint,  anas,  with  the 
one  of  opposite  side,  superior  articular  and  anterior  tibial  re- 
current. 

TIBIA'LIS  ANTE'BIOS:  (3  branches);  forward  through  in- 
terosseous  membrane  and  2  heads  of  tibialis  posticus,  lying 
upon  anterior  surface  of  interosseous  membrane  down  to  front 
of  ankle,  there  becoming  dorsalis  pedis.  A  line  drawn  from 
inner  fibular  head  to  midway  between  the  2  malleoli  indicates 
its  course.  Has  venae  comites;  the  anterior  tibial  nerve  lies  a 
little  superficial  and  to  its  outer  side.  Becur'rons  \  arises  just 
as  artery  passes  through  interosseous  membrane,  running  up 
in  tibialis  anticus  muscle  to  front  of  joint,  anas,  with  the  articu- 
lares.  Muscda'res  :  numerous,  supplying  integument  and  mus- 
cles throughout  the  course;  anas,  with  branches  from 
posterior  tibial  and  peroncal.  Malleola'res :  internal  arises  2 


4«  LOWER   EXTREMITY. 

inches  above  articulation,  inwards,  beneath  tendons  ramify- 
ing upon  inner  malleolus,  anas,  with  branches  from  posterior 
tibia  and  internal  plantar.  External,  outwards  beneath  ten- 
dons, supplying  outer  malleolus,  anas,  with  anterior  peroneal, 
and  tarsea  branch  of  dorsalis  pedis. 

DOESA'LIS  lE'DIS:  (4  branches) ;  from  bend  of  ankle  to  ist 
interosseous  space,  there  dividing  into  communicating  and 
dorsalis  hallucis.  Venae  comites;  anterior  tibial  nerve  lies  on 
outer  side.  Tar'sea  I  arises  over  scaphoid,  passing  outwards 
beneath  extensor  brevis  digitorum,  supplying  that  muscle  and 
tarsal  articulations  ;  anas,  metatarsal,  external  malleolar,  pe- 
roneal, and  external  plantar.  Metatar'sea:  outwards  over 
metatarsal  heads,  giving  off  3  interos'sece  branches  which  pass 
forwards  to  clefts  of  the  3  outer  toes,  there  dividing  to  supply 
adjacent  sides  of  the  toes,  and  outer  side  of  little  toe.  Anas. 
with  tarsea  and  external  plantar;  the  3  interosseous,  each, 
receive  a  posterior  perforating  branch  from  plantar  arch  near 
their  origin,  and  each  a  branch  from  anterior  perforating  of 
digital  near  the  toe-clefts.  Dorsa'lis  hal.n'cis  :  forwards  along 
outer  border  ist  metatarsus  to  ist  toe-ciel't,  there  dividing  to 
supply  inner  side  of  big  toe,  and  the  adjacent  sides  of  big  and 
ad  toes.  Commn'mcana  :  dips  down  into  sole,  anas,  with  external 
plantar  to  form  pUniar  arch,  there  dividing  to  supply  toes 
same  as  dorsalis  hallucis. 

TIBIA'LIS  POSTE'EIOS :  (5  brs.);  from  lower  border  popliteus, 
parallel  inner  border  tendo  Achillis,  to  fossa  between  inner 
ankle  and  heel,  there  dividing  into  the  plantar  arteries.  Has 
venae  comites;  nerve  to  the  outside  for  the  lower  %  of  its 
course.  Peronse'a:  from  i  inch  below  popliteus,  obliquely  out- 
wards to  fibula,  descending  along  inner  border  of  it  to  outer 
ankle,  supplying  contiguous  structures,  anas,  with  external 
malleolar,  tarsal,  and  external  plantar.  Ante'rior  peron&'a, 
given  off  2  inches  above  ankle,  piercing  interosseous  mem- 
brane, passes  down  to  front  of  outer  ankle  and  tarsus,  sup- 
plying adjacent  structures,  anas,  with  tarsal  and  external 
malleolar.  Nutri'tia,  to  fibula.  Muscula'res,  to  fibular  mus- 
cles. Nutri'ta:  near  origin  of  posterior  tibia,  being  largest  of 
its  kind  in  the  body;  enters  tibia  just  below  oblique  line. 
Mnscula'res :  to  soleus  and  deep  muscles.  C.mmu'nicans :  trans- 
versly  across  tibia  2  inches  above  its  inferior  extremity  to 
anas,  with  peroneal.  Calca'nes  interna'les :  several  branches 
arising  just  before  division  of  posterior  tibial,  supplying  fat 
and  integument  about  heel,  and  muscles  of  inner  side  of  foot* 
anas*  with  peroneal,  internal  malleolar. 


ARTERIES— VEINS.  43 

PLANTA'PIS  INTES'lTA:  forwards  along  inner  side  of  foot  to 
big  toe,  anas.  \vuh  digital  branches,  supplies  abductor  pollicis, 
flexor  brevis  dlgitorum,  etc. 

PLA..TA'E.S  EXTSE'NA:  (2  brs.);  out- and  forwards  to  base 
5th  metatarsus,  then  turning  obliquely  inwards  to  ist interos- 
seous  space,  inosc.  with  communicating  branch  from  dorsalis 
peclis,  forming  plantar  arch.  Perforates  pOSterlo'reS :  (3);  ascend 
through  back  part  of  the  3  outer  intcrosscous  spaces  J  anas. 
with  interosseous  branches  of  metatarsal.  Digita'.GS  :  (4) ;  arise 
from  arch  and  supply  both  sides  of  the  3  outer  toes  and  outer 
side  of  the  2d  toe,  bifurcating  at  the  respective  toe-clefts  to  do 
this.  At  each  bifurcation  a  branch  (the  anterior perforating) 
is  sent  upwards  through  the  interosseous  space ;  anas,  with 
interosseous  branches  of  the  metatarsal. 


VEINS. 

Sapho'na  inter'ni,  or  long  saphenous  :  from  plexus  at  dorsum 
and  inner  side  of  foot,  ascends,  in  front  of  inner  ankle,  be- 
hind inner  margin  of  tibia,  bends  behind  inner  femuric  con- 
dyle,  empties  into  femoral  through  saphenous  opening,  \yz 
inches  below  Poupart's ligament,  where  it  receives  superficia- 
'Us  circumflex' a  il?acat  superficia'lis  epigas'trica,  and  super- 
ficia'lis  exter'na  pudi'ca.  Communicates  with  internal  plan- 
tar, tibial,  etc.  2 — 6  valves. 

Saphe'aa  c xter'm :  plexus  at  dorsum  and  outer  side  of  foot, 
up  behind  outer  ankle  to  median  line  of  leg,  accompanied  by 
external  saphenous  nerve;  empties,  into  poplite,.!  vein,  be- 
tween heads  of  gastrocnemius.  2  valves,  one  near  termina- 
tion. Communicates  with  deep  veins  of  foot. 

Tibia'lS3  po.terio'res:  formed  from  external  and  internal 
plantar  joining  with  the  peroneal.  Course  same  as  artery. 

Tib. lies  cnerio'res:  continuation  oivc'nce  dorsa'les  petdist 
pierce  interosseous  membrane  at  upper  part  of  leg,  and  form, 
by  junction  with  the  posterior  tibial  veins,  the  popliteal. 

Poplitx'a:  (see  tibial  anterior)  up  to  tendinous  aperture  of 
adductor  magnus,  there  becoming  the  femoral;  receives 
fural,  articrtlar,  and  external  sapJienous  veins.  4  valves. 
Crosses  artery  from  within  outwards. 

Femoralis:  (see  above);  up  to  Poupart's  ligament,  there 
becoming  external  iliac.  Lies  (below)  to  outside,  but  crosses 
beneath  the  artery  to  its  inside.  Receives  muscular  branches, 
&D.&profun'dajfemo'rist  and  internal  sapJienoiis  at  i%  inches 
below  Poupart's  ligament.  4  or  5  valves. 

QSter'na :  (see  above) ;  to  sacro-iliac  symphysis,  there 


44  LOWER   EXTKKMltY. 

uniting  with  internal  iliac  to  form  common  iliac.  Ori  right  side, 
lies  to  inside  of  artery  at  first,  but  gradually  passes  behind  it. 
On  left  side,  altogether  on  inside  of  artery.  Receives  epigas* 
trie  and  circumflex  iliact  No  valves. 

Hi'-OlL.er'aa:  formed  by  venae  comites  of  all  the  branches 
of  the  iliac  artery,  but  the  umbilical;  lies  first  to  inside,  but 
finally  gets  behind  the  artery.  No  valves,  though  the  plexu* 
that  help  form  it  are  abundantly  supplied.  I.  H&rttorrhoidal 
pi, -x  us';  t.  VesicO'prostatic  plex.J  3.  vaginal  plex.;  4.  uterint 
plex.;  5.  dorsalis  pent*  plex.;  these  all  intercommunicate 
very  freely. 

lliaca  COamU'dsS  (see  iliaca  externa);  terminates  at  inter-* 
Vertebral  substance  between  4th  and  5th  lumbar  Vertebra, 
there,  with  its  fellow  of  opposite  side,  forms  vena  cava  infe» 
rior.  On  the  right  it  is  the  shorter,  and  nearly  vertical. 
Receives  ilio-lumbar.  and  sometimes  lateral  sacral  veins* 
Middle  sacral  empties  into  left  common  iliac.  No  valves* 

NERVES, 

LUM'BAB  PLEZ'wS  :  formed  by  anterior  roots  of  th*  4  upper 
lumbar  nerves  communicating  with  each  other.  It  furnished 
diiTcrent  nervous  branches  to  supply  the  inferior  extremities, 
II  0-h7PO£as'trica  \  ist  lumbar,  outwards  to  iliac  crest,  piercing 
there  the  transversahs,  the  iliac  branch  being  distributed  to 
gluterJ  integument;  the  hypogastric  supplies  the  integument 
in  umbilical  region.  Hio-i  guiia'lis:  ist  lumbar;  escapes  at 
external  ring,  supplying  inner  thigh,  scrotum  (labia  in  female) 
and  inguinal  region.  Gtett,tO-CUra'.i3 1  zd  lumbar  and  branch 
from  ist,  pierces  psoas,  and  near  Poupart's  ligament  divides  ; 
the  genital  branch  to  genitals,  the  crural  to  integument  on 
anterior  upper  aspect  of  \\i.gh\comtnuntcates  with  midd'.e 
cutaneous.  Cuta'aSH*  tlter'nu, :  2d  lumbar  ;  perforates  pso:,s, 
and  at  Poupart's  ligament  divides  ;  the  anterior  branch  sup- 
plying the  anterior  and  external  part  of  thigh  to  knee  :  the 
posterior,  supplying  posterior  surface  of  thigh  to  its  middle. 
Obtura'tor:  3d  and  4th  lumbar,  and  at  upper  part  of  obturator 
foramen  enters  thigh,  dividing  into:  anterior  branch  supply- 
ing adductor  longus  and  brevis,  pcctincus  and  femoral  artery, 
giving  articular  branch  to  hip-joint ;  posterior  branch  pierces 
obturator  externus,  passes  to  front  of  adductor  magnus,  di- 
viding into  muscular  branches;  articular  branch  is  given  off 
for  knee-joint.  Obtwa'tOT  accesso'lius  :  either  from  obturator,  or 
filaments  from  3d  and  4'.h  lumbar;  supplies  pectincus,  hip- 
joint,  and  a  cutaneous  branch  to  leg.  Sometimes  wanting. 


NERVES.  45 

ANTETJIOB  CRUBA'LIS  I  3^  »nd  4th  lumbar,  through  psoas 
beneath  Poupart's  ligament  to  thigh,  external  to  artery  in 
pelvis,  supplies  iliacus,  and  femoral  artery;  without,  all  the 
muscles  on  front  of  the  thigh  but  the  tensor  vaginae  femoris. 
Cata'ne'iS  me'd.m:  through  fascia  lata  below  Poupart's  ligament, 
dividing  inio  2  branches,  supplying  sartorius  and  integument 
in  front  as  low  as  knee.  Cut  /HGUS  fat T'HU3,  obliquely  across 
upper  part  femoral  sheath,  the  anterior  branch  perforating 
fascia  at  lower  3d  of  thigh,  supplies  integument  of  inside  of 
thigh  to  kne^-joint;  the  inner  branch  descends  along  posterior 
border  sartorius  to  knee,  piercing  fascia,  giving  off  numerous 
branches,  descending  still  farther,  supplying  integument  of 
inner  side  of  leg.  Sap-6'nU3  intorLus,  downwards  beneath  sar- 
torius to  knee,  inner  side,  then  along  inner  side  of  leg  in 
company  with  internal  sophenous  vein,  dividing  into  2 
branches,  one  terminating  at  inner  ankle,  the  other  distribu- 
ted to  integument  of  dorsum  of  foot.  Supplies  muscles  and 
integument  in  its  course,  giving  off  branches  communicating 
with  internal  cutaneous  and  obturator  nerves ;  another  to 
patellar  integument  and  forms  a  * '  plexus  patellae  "  with  othar 
branches.  Ifil.CUla'reS,  all  muscles  of  front  of  leg  but  tensor 
vaginae  fcmons.  Articula'res,  i  to  knee-joint  ligaments. 

SACI»A'_S3  :  5;  the  4  upper  through  anterior  sacral  canals, 
the  5.h  through  the  sacro-coccygeal  foramen  ;  the  posterior 
are  smaller  and  through  posterior  sacral  canals,  except  the 
5th,  which  is  through  posterior  sacro-coccygeal  foramen. 
Have  long  roots .  Posterior  internal  branches  supply  multi- 
fidusspinx.  Posterior  external  branches  supply  integument 
over  sacrum,  coccyx  and  posterior  gluteal  region,  forming 
many  anastomosing  loops.  Anterior,  the  4  upper  supplying 
rectum,  bladder,  (vagina)  and  pelvic  viscera  (communicating 
with  sympathetic),  wi.h  their  muscular  branches  supplying 
Icvator  ar.i,  coccygeus,  sphincter  ani,  and  integument  be- 
tween anus  and  coccyx.  The  5th  pierces  coccygrus  muscle, 
supplies  integument  over  coccyx,  communicating  with  coccy- 
geal. 

COCCiaEA'LIS :  posterior  branch  receives  branch  of  com. 
from  postc.ior  sacral  and  is  lost  in  fibrous  cover  of  coccyx. 
Anterior  branch  pierces  sacro-sciatic  linament,  supplying 
integument  about  coccyx.  Anas.  5th  sacral. 

SA'C2AL  PLSZ'US;  is  formed  by  lumbo-sacral,  the  anterior 
branches  of  3  upper  (and  part  of  the  4th)  sacral  nerves.  Is 
triangular  in  form,  the  base  corresponding  to  the  exits  of 
nerves,  and  rests  on  pyriformis,  anterior  surface,  covered  by 


<|6  LOWER  EXTREMITY. 

fascia.  liuSWla'rSS!  supply  pyriformis,  obturator  internus, 
gemelli,  and  quadutus  femoris.  Qlutse'US  Stlps'lior :  back  part 
1  umbo-sacral,  passes  through  grxat  sacro-sciatic  foramen,  the 
siiperior  branch  supplying  glutseus  minimus  and  medius,  the 
inferior  branch  supplying  glutseus  minimus  and  medius,  and 
lower  portion  tensor  vaginae  femoris.  Pudi'CBSI  plexus,  lower 
part;  out  great  sciatic  foramen,  in  through  the  lesser  sacro- 
sciatic  foramen,  terminating  in  perineal  and  dorsal  nerves  of 
penis.  Inferior  h&morrhoida! Us >  near  origin  pudic,  supplies 
external  sphincter  and  adjacent  integument,  communicates 
with  inferior  pudendal  and  superficial  perineal.  Perince'us9 
terminal  branch,  accompanies  perineal  artery  ;  the  anterio\ 
cutaneous  branches  supply  scrotum  and  under  part  of  penis, 
(labia),  and  levator  ani ;  the  posterior  branches  supp! 
sphincter  ani  and  integument  in  front  of  anus,  and  back  par 
scrotum.  The  muscular  branches  supply  transversus  perinaei, 
accelerator  urinae,  erector  penis,  compressor  urethrae,  and 
bulb.  Dorsa'lis pe'nis,  along  ramus  ischii,  with  puciic  artery, 
follows  it  and  its  branches  to  the  glans  penis,  which  it  sup- 
plies. Anas,  with  sympathetic,  supplies  integument  of  pre- 
puce and  of  penis,  and  corpus  cavernosum.  (In  female,  to 
the  analogous  parts.) 

SCIAT'ICUS  PAB'VTIS:  supplies  integument  of  perinseum, 
"back  part  of  thigh  and  leg,  and  glutseus  maximus.  Two 
branches  from  sacral  plexus  unite  to  form  it;  follows  course 
of  sciatic  artery  in  distribution,  piercing  fascia  in  popliteal 
region,  accompanies  external  saphenous  vein  to  middle  of 
leg.  Inferio'res  glutce'i,  to  gltitaeus  maximus,  several  large 
branches.  Inter'nal  cuta'nei,  to  skin  of  upper  and  inner  side 
of  thigh,  posterior  aspect;  scrotum  by  inferior  pudemial  that 
curves  around  tuber  ischii.  Ascended tes  cufa'nei,  run  upwards 
and  supply  integument  of  gluteal  region,  and  muscles. 
Branches  to  integument  of  thigh,  popliteal  region  and  upper 
part  of  leg. 

SCIAT'ICUS  MAG'iTUS:  ^  inch  wide,  and  continuation  of 
lower  part  sacral  plexus,  passing  out  of  great  sacro-sciatic 
foramen  below  pyriformis,  down  between  great  trochanter 
and  tuber  ischii  to  lower  3d  of  thigh,  there  dividing  into  inter- 
nal and  external  poplitseus.  Articula'res,  to  hip-joint  and 
capsule.  Muscula*res,  to  flexors  of  the  leg,  adductor  magnus, 
in  tegument  of  the  back  part  of  thigh  also  supplied  by  this 
nerve. 

POPLITJE'US  INTEB'NUS;  (see  above);  largest  terminal 
branch;  down  through  middle  of  popliteal  space,  beneath 


NERVES.  47 

soleac  arch  becoming  posterior  tibial.  Articula'res,  (3) ;  knee- 
joint,  accompanying  superior  internal  articular,  inferior  in- 
ternal articular,  and  azygos  arteries.  Muscula'res,  (4  or  5XtO 
gastrocnemius,  plantaris,  solcus  and  popliteus.  Saphe'nus  ex- 
ter'nus,  down  between  gastrocnemius  heads,  to  middle  of  leg, 
there  piercing  fascia  and  anas,  with  communicans  peronsei, 
then  down  along  outer  margin  of  tendo  Achillis  in  company 
with  vein,  supplying  integument  of  outer  side  of  foot  and  lit- 
tle toe,  communicates  with  musclo-cutaneous. 

T.BIA'LIS  POSTE'BIOB:  from  lower  border  poplitseus  passes 
down  leg  with  posterior  tibial  artery,  between  heel  and  inter- 
nal ankle,  there  dividing  into  external  and  internal  plantar  ; 
above  lies  to  inside  of  artery,  below  to  outer  side.  Muscula'reS, 
to  tibialis  posticus,  flexor  longus  digitorum,  and  poliicis. 
Cuta'neua  planta'ris,  perforates  internal  annular  ligament,  sup- 
p'.ying  integument  of  heel  and  inner  side  of  sole  of  foot. 
Plaata'ris  inter'miS  :  (see  above)  largest  terminal  branch  accom- 
panying internal  plantar  artery  along  inner  side  of  foot. 
Cuta'nei,  to  sole  of  foot.  Muscula'res,  to  flexor  brevis  digito- 
rum, and  abductor  poliicis.  Articula'res,  to  tarsus  and  met- 
atarsus. Digita'les,  (4) ;  supplying  the  first  3  toes  (both  sides) 
and  inner  margin  of  the  4th  toe,  integument,  articulations, 
nails,  etc.,  and  ist  and  2d  lumbricales.  Planta'ris  exter'nus: 
(see  tibial  posterior)  follows  course  of  its  artery  to  outer  side 
of  foot,  supplying  little  toe  and  outer  half  of  4th  toe,  and 
structures  adjacent,  flexor  accessorius,  and  abductor  minimi 
digiti.  Superficial 'Us  branch  goes  to  outer  side  of  $th  and 
adjacent  sides  of  4th  and  5th  toes,  flexor  brevis  minimi  digiti, 
and  the  2  interossei  of  4th  metatarsal  space.  Deep  branch 
supplies  remaining  interossei,  2  outer  lumbricales,  adductor 
poliicis,  transversus  pedis. 

POPLIT,E'US  EZTEB'TO  (or  perona^us) ;  %  size  of  internus 
poplitseus  (see  great  sciatic);  descends  along  outer  margin  of 
popliteal  space  to  fibula,  and  about  i  inch  below  its  head 
divides  into  anterior  tibial  and  musculo-cutaneous.  ArtlCUla'- 
res:  (2)  accompanies  external  articular  arteries  to  outer  side 
of  knee.  Sometimes  a  30!  is  given  off  as  a  recurrent,  which 
supplies  front  of  knee.  Cllta'nei,  (2  ©r  3);  supply  integument  of 
back  and  outer  side  of  leg  as  far  as  its  lower  3d.  CoUffim'nicans 
peronss'i,  arises  near  fibular  head,  joining  External  saphenous 
at  middle  of  leg.  Tibia'lis  ante'rior :  (see  above)  passes  obliquely 
forwards  to  front  of  interosscous  membrane,  reaching  outer 
side  of  anterior  tibial  artery  at  middle  of  leg,  descending 
thence  to  front  of  ankle  it  divides  into  external  and  internal 


48  OSTEOLOGY. 

branches.  Muscula'res,  to  tibialis  anticus,  extensor  longns 
digitorum,  extensor  proprius  pcllicis.  Exter'nal  or  tar>seust 
outwards  across  tarsus,  supplies  external  brevis  digitorum, 
and  articulations  of  tarsus  and  metatarsus;  becomes  gangli- 
onic.  Internal  branch  accompanies  dorsalis  peclis  artery, 
supplying  ist  interrosseous  space  and  adjacent  sides  ist  and 
2d  toes,  communicates  with  internal  division  of  musculo- 
cutaneous.  Mus'CUlo-CCta'aeua  I  supplies  muscles  of  fibukr  side 
of  leg  and  dorsal  integument  of  loot  (see  poplitae'us  exter'nus). 
At  lower  3d  of  leg  (its  front  and  outer  side)  divides  into  inter- 
nal and  external  branches.  Muscula'res,  fibular  muscles  and 
integuments.  Internal  branch,  down  in  front  of  ankle  to 
supply  inside  of  great  toe  and  adjacent  sides  of  2d  and  3d 
toes,  integument  of  inner  ankle  and  inside  of  foot  j  communi- 
cates with  internal  saphenous  and  anterior  tibial.  External 
branch,  down  outer  side  dorsum  of  foot  to  supply  adjacent 
sides  of  3d,  4th  and  5th  toes,  integument  of  outer  ankle  and 
outer  side  of  foot ;  communicates  with  external  saphenous. 

OSTEOI^OOY. 

NOTE. — Muscles  in  italics ,  are  muscles  of  insertion.  Fig- 
ures in  [  ]  show  the  primary  number  of  ossific  centres,  and 
date  of  appearance  of  ossification. 

COMPOSITION:  Gelatine  and  blood-vessels,  33.30;  calcic' 
phosphate,  51.04  ;  calcic  carbonate,  11.30 ;  calcic  fiouride,  2.00; 
m?gncsic  phosphate,  x.i6;  sodic  chloride  and  oxide,  1.20; 
total,  100.00. 

1H7M3EB:  verteb'ral  column  (including  sacrum  and  coccyx) 
26;  cranium,  8;  ossiculi  auu*tus,  6;  face,  14;  hyoid,  sternum 
and  ribs,  26;  upper  extremity,  64;  lower  extremity,  60;  total, 
204.  To  this  may  be  added  the  patellae  and  teeth,  making  a 
grand  total  of  238. 

SPINS  has  33  vertebrae,  viz.:  7  cervical,  12  dorsal,  slum- 
bar,  5  sacral,  4  coccy^eul.  They  each  have  a  body,  7  pro- 
cesses, 2  pedicles,  2  laminae,  4  notches,  and  a  foramen.  The 
Wrvical  are  noted  for  the  smallness  and  broadness  of  body, 
bifid  spinous  processes,  bifid  and  perforated  transverse  pro- 
cessses,  etc.  The  peculiar  are  the  ist,  or  atlas,  which  is  like 
a  ' '  ring ;"  the  2d,  or  axis,  having  a  large  (odontoid)  process ; 
the  7th,  or  fromincns,  having  a  long  spinous  process.  The 
dorsal  have  body  largest  antero-posteriorly,  spinous  processes 
directed  downwards,  facets  for  ribs.  Peculiar  are  the  ist, 
having  one  whole  facet,  the  rest  demi-facets  for  the  ribs  ;  icM, 
\\th  and  iz/A,  each  having  a  distinct  facet  for  a  rib.  tiiusclcs: 


OSTEOLOGY.  49 

to  the  atlas  are  attached  xo;  to  the  axis,  xt ;  to  the  remaining 
(anterioriy)  10,  (posteriorly)  22.  [The  vertebrae  are  developed 
from  3  centres  by  ossification,  the  first  appearing  at  6th  week  ; 
at  sixteen  4  secondary  centers  appear,  and  at  twenty-one  a 
circular  plate  for  superior  and  inferior  surfaces  of  body.  A 
few  exceptions,  as  atlas  (2  primitive  centers),  axis  (6),  jth 
cervical  and  the  lumbar  (5).] 

Sa'crna  :  triangular,  anterior  and  posterior  foramina,  lateral 
masses,  laminae,  tubercular  transverse  processes,  promontory, 
sacral  canal  and  groove,  auricular  surface.  Articulations  (4);  • 
innominate,  5th  lumbar,  coccyx.  Musc!est  (5) ;  pyrifcrm, 
coccygeus ,  glutaeus  maximus,  erector  spin®,  latissimus  dorsi. 
£35,  8th  week.] 

Ccc'CyX :  cornua.  Articulation,  (i)j  sacrum.  Muscles,  (4)  j 
coccy^eus,  glutaeus  maximus,  sphincter  and  levator  am.  [4, 
birih  to  puberty.] 

Occi^lta'lo:  superior  and  inferior  curved  lines,  crest,  pro* 
tuberancc,  foramen  magnum,  condyles,  basilar  and  jugular 
processes,  pharyngeal  spine,  anterior  and  posterior  conc?y*- 
loid  foramina ;  fossae  cerebri  et  cerebelli,  torcula  protuberance, 
grooves  for  occipital,  lateral,  inferior  petrosal,  superior  longi- 
tudinal sinus  and  medulla,  jugular  fossa.  Artie.  (6^;  2  parietal^ 
a  temporal,  sphenoid,  atlas.  Muse.  (12)  ;  occipito- fronta'.is, 

*  trapezius,  sterno-cleido-tnastoid,  complexus,  tplenius  capitis^ 
obliquus  superior,  rectus  Posticus    major  and  minort  rcctu* 
lateralist  rectus anticu s  major  and  ntinort   superior  pharynr 

-  geus,  constrictor.     [4,  xoth  week.] 

Pariotale:  eminence,  foramtn,  temporal  ridge;  Pacchio- 
nian  dcpres  ions>  mi  ^dle  meningeal  groove,  superior  lon£itu» 
dinr.l  and  lateral  sinus.  Artie.  (5)  ;  fellow,  occipital,  frontal, 
temporal,  sphenoid.  Muse,  (i)  ;  temporal,  [i.] 

Pronta'e:  eminence,  supercilliary  ridges,  external  and 
internal  angular  processes,  supra-orbital  notches  and  arches, 
temporal  ridges  and  fossae,  nasal  eminence  and  spine;  orbital 
plates,  lachrymal  fos^a,  pulley  depression,  ethmoid  notchf 
anterior  ethmoid  foramina,  foramen  caecum,  meningealgroovcsf 
Pacchionian  depressions,  frontal  and  superior  longitudinal 
sinus  (frontal  suture).  Artie.  (12)52  parietal,  sphenoid,  cth* 
moid,  a  nasr.l,  2  superior  maxillae,  2  lachrymal,  2  malar.  Muse. 
(3  pr.);  corrugator  supercilii,  orbicularis  palpebrarum,  tempo* 
ral.  [a.] 

TeapOPilft  •  zygoma,  articular  eminence,  glenoid  fossa, 
Glasserian  fissure,  vaginal,  styloid,  mr,stoid  and  auditory 
processes,  mastoid  foramen,  superior  and  inferior  petrosal 
4 


50  OSTEOLOGY. 

and  lateral  sinus,  aquaeductus  vestibuli,  meatus  auditorius  in* 
ternus,  hiatus  Fallopii,  opening  for  smaller  petrosal  nerve, 
depression  Casserian  ganglion,  carotid  canal,  openings  for 
Jacobson's  and  Arnold's  nerves,  aquaeductus  cochleae,  jugu- 
lar fossa,  stylo-mastoid  foramen,  auricular  fissure,  canal  for 
Eustachian  tube,  and  tensor  tympani.  Artie.  (5) ;  occipital, 
parietal,  sphenoid,  inferior  maxilla,  malar.  Muse.  (14) ; 
temporal,  masseter,  occipito-frontalis,  sterno-mastoid,  sple- 
nius  caj>itis,  trachelo-mastoid,  digastric,  retrahens  aurem, 
stylo-pharyngeus,  stylo-hyoid,  stylo-glossus,  levator  palati, 
tensor  tympani,  stapedius.  [4,  8th  week.] 

Spheaoi'des  I  ethmoid  spine,  optic  groove,  olivary  process, 
seila  turcica,  anterior  middle  and  posterior  clinoid  processes, 
cavernous  groove  ;  foramina  opticum,  lacerum  anterius,  rotun- 
dum,  Vesalii,  ovale,  spinosum  ;  spinous,  hamular,  vaginal  and 
external  and  internal  pterygoid  processes;  rostrum,  petery- 
goid  notch  and  ridge,  scaphoid,  pterygoid,  temporal  and 
zygomatic  fossae,  Vidian  and  pterygo-palatine  canals.  Artie. 
(12);  all  of  cranium  and  2  malar,  2  palate  and  vomer.  Muse. 
(izpr.);  temporal,  external  and  internal  pterygoid,  superior 
constrictor,  tensor  palati,  laxator  tympani,  levator  palpebrae, 
obliquus  superior,  internal  and  external  recti,  superior  and 
inferior  recti.  [10,  8th  w.] 

JJthmoi'deS :  crista  galli,  infundibulum,  os  planum,  tinci- 
form  process,  olfactory  foramina,  superior  meatus,  anterior 
and  posterior  cells.  Artie.  (15);  sphenoid,  frontal,  2  sphcnoi- 
dal  turbinated,  2  nasal,  2  superior  maxillary,  2  lachrymal,  2 
palate,  2  inferior  turbinated,  vomer.  Muse.  none.  [3,  4th  m.] 

Hassle!  groove  for  nasal  nerve.  Artie.  (4)  j  frontal,  eth- 
moid, fellow,  superior  maxilla.  Muse.  none,  [i,  8th  w.] 

Mazilla'rs  SBpe'rior  ;  nasal  process  lachrymal  tubercle, orbicu- 
lar surface,  infra-orbital  groove  and  foramen,  canine  and  in- 
cisive fossa,  canine  eminence,  alveolar  process,  posterior 
dental  canals,  maxillary  tuberosity,  middle  and  inferior 
meatus,  palate  process,  anterior  and  posterior  palatine  canals  ; 
antrum.  Artie.  (9);  frontal,  ethmoid,  nasal,  malar,  lachrymal, 
inferior  turbinated,  palate,  vomer,  fellow.  Muse.  (9);  orbicula- 
ris  palpebrarum,  inferior  obliquus  oculi,  levator  labii  superi- 
oris alaeque  nasi,  levator  labii  superioris  proprius,  levator  anguli 
oris,  compressor  naris,  depressor  alae  nasi,  masseter,  buccina- 
tor. [4,  early.] 

Lachryaalo  :  lachrymal  groove.  Artie.  (4) ;  frontal,  ethmoid, 
superior  maxilla,  inferior  turbinated.  Muse,  (i);  tensor  tarsi. 
LI,  8th  week.] 


OSTEOLOGY.  jt 

'ro :  frontal,  rygomatic,orbital  and  maxillary  processes, 
temporo-malar  canal,  Artie.  (4);  frontal,  sphenoid,  temporal, 
superior  maxilla.  Muse.  (5;;  levator  labii  superioris  proprius, 
zygomaticus  major  and  minor,  masseter,  temporal,  [i,  8th 
week.] 

Ospala'll:  orbital,  maxillary,  and  sphenoid  processes, 
spheno-palatine  foramen,  superior  meatus  and  superior  turbi- 
nated  crest,  middle  meatus  and  inferior  turbinated  crest, 
inferior  meatus  ;  posterior  palatine  canal,  tuberosity,  poste- 
rior nasal  spine.  Artie.  (7)  ;  sphenoid,  ethmoid,  superior 
maxilla,  inferior  and  superior  turbinated,  vomer,  fellow. 
Muse.  (4);  tensor  palati,  azygos  uvulae,  internal  and  external 
petergoid.  [i,  — .] 

Turb-na'tnm  infe'rior:  lachrymal,  ethmoid  and  maxillary  pro- 
cesses. Artie.  (4);  ethmoid,  superior maxilla,lachrymal,  palate. 
Muse,  none  [i,  4th  month.] 

Vo'me: :  naso-palatine  groove.  Artie.  (6)  ;  sphenoid,  eth- 
moid, 2  superior  maxilla,  2  palate.  Muse.  none.  [2,  8th  week.] 

Manlla'rd  Lfe'rior:  coronoid  process,  condyle,  ramus,  sig- 
moid  notch,  mental  foramen  and  process,  symphysis,  groove 
for  facial  artery,  inferior  dental  foramen,  mylo-hyoid  groove 
and  ridge,  sublingual  and  submaxillary  fossse,  genial  tuber- 
cles. Artie.  (2);  2  temporal.  Muse.  (14  pr.) ;  levator  menti, 
depressor  labii  inferioris,  depressor  anguli  cris,  platysma, 
buccinator,  masseter;  genio-hyo-glossus,  genio-hyoid,  mylo- 
hyoid,  digastric,  superior  constrictor,  temporal,  internal  and 
external pterygoid.  [2,  early.] 

Hyoi'd03 :  greater  and  lesser  cornua,  body.  Artie,  none. 
Muse,  (n)  \sterno-,  thyro-,  onto-,  stylo-,  mylo-  and  genio-hyoid, 
genio-hyo-glossus,  hyo-glossus,  middle  constrictor,  lingualis, 
pulley  of  digastric.  [5,  8th  month.] 

Stcr'num:  ntanu'brtum,  gladiolus,  en'stform  appendix ; 
facets  for  7  superior  ribs.  Artie.  (16) ;  7  pairs  r:bs,  2  clavicles. 
Muse.  (10) ;  pectoralis  major,  sterno-mastoid,  sterno-hyoid  and 
sterno-thyroid,  triangularis  sterni,  obliquus  externus  and  in- 
ttrnus,  transversalis,  rectus,  diaphragm.  [6,  sth  month.] 

Co:'te  (ribs):  head,  neck,  tuberosity,  articular  and  non- 
articular  protuberances,  angle,  facets  for  superior  anc  infcr.cr 
vertebrae.  Artie.  (24) ;  vertebra*  and  costal  cartilages.  Muse. 
(J9)  i  [3  «ach,  save  the  last  two,  these  but  2;  early.)  Peculiar 
ribs :  u/,  shortest,  most  curved,  horizontally  placed,  haring 
grooves  for  subclavian  artery  and  vein  ;  2^,  some  larger  than 
xst,  is  not  twisted,  etc.;  zoM,  single  articular  facet;  u/A  and 
I2/A,  single  articular  facet,  no  neck  or  tuberosity. 


58  OSTEOLOGY. 

Costal  CirVlagOS  :  artic.  with  sternum  and  ribs.  Muse.  (10); 
subclavius,  sterno-thyroid,  pectoralis  major,  interxus  ob- 
liquus,  transversalis,  rectus,  diaphragm,  internal  and  exter- 
n:.l  intercostal,  triangularis  sterni.  (The  last  3  are  muscles  of 
Origin  and  insertion.) 

C-47ic'ttla  :  shape  of  letter./";  sternal  and  acromial  extremi- 
ty ;  oblique  line,  tuberosity,  rhomboid  impression.  Artie.  (3); 
sternum,  scapula,  ist  costo-oartilage.  Muse.  (6>  ; sterno-mas- 
tcid  and  sterno-hyoid,  trapezius ,  pectoralis  major,  deltoid, 
subclavius.  [2,  first  of  all.] 

Scip'ula;  acromian  and  coracoid  processes,  glenoid  caivty, 
neck,  subscapular  fossa,  ridges;  supra-scapular  notch,  supra- 
and  infra-spinous  fossae,  spine,  groove  for  dorsalis  scupula 
vessels.  Artie.  (2) ;  clavicle,  humerus.  Muse.  (17);  subscapu- 
laris,  supra- and  infra-spinatus,  trafezius,  deltoid,  omo-hyo'd, 
serratus  »iagnus,  levator  anguli  scapula1,  rhomb&ideus  •m&jor 
and  minor ,  triceps,  tercs  major  and  minor,  biceps,  coraco- 
brachialis,/<r«r/tfra//.r  minor,  latissimus  dorsi  [7,  8th  w.] 

Hu'merus:  he..d,  anatomical  and  surgical  necks,  greater 
and  lesser  tuberosiiies,  bicipital  ridge  and  groove,  posterior 
bkipital  ridge,  rough  deltoid  surface,  internal  and  external 
condyles,  coronoid  and  radial  depressions,  radial  head, 
trochlear  surface;  musculo-spiral  groove,  olecranon  depres- 
sion. Artie. (3);  scapula,  ulna,  radius.  Muse.  (24);  supra- 
and  infra-spinalus ,  teres  major  and  minor,  snbscapularis, 
fcctoralis  major,  latissimus  dorsi,  deltoid,  coraco-brachialis, 
brachialis  anticus,  triceps;  pronator  radii  tercs,  flexor  carpi 
radialis,  palmaris  longus,  flexor  sublimis  digitorum,  flexor 
carpi  ulnaris ;  supinator  longus,  extensor  carpi  radia!is 
longior  and  brevior,  extensor  communis  digitorum,  extensor 
minimi  digiti,  extensor  carpi  ulnaris,  anconeus,  supinator 
brevis.  [7,  early.] 

Ul'zi:  olecranon,  greater  and  lesser  sigmoid  cavities,  cor- 
onoid process,  nutrient  foramen,  styloid  process  ;  oblique 
line,  groove  for  extensor  carpi  ulnaris.  Artie.  (2) ;  humcrus, 
radius.  Muse.  (13) ;  triceps,  ancontus,  flexor  and  extensor 
carpi  ulnaris,  brachialis  anticus,  pronator  radii  teres,  flexor 
sublimis  and  profundus  digitorum,  pronator  quadratus,  supi- 
nator brevis,  extensor  ossis  metacarpi  and  extensor  secundi 
internodii  pollicis,  extensor  indicis.  [3,  5th  w.] 

Ba'diuS!  head,  neck,  bicipital  tuberosity,  oblique  line, 
nutrient  foramen,  styloid  process,  2  grooves ;  4  grooves  for 
extensor  muscles.  Ari:c.  (4);  humerus,  ulna,  scaphoid,  semi- 
lunar.  M:i*c.  (9) ;  b'ccps,  supinator  longus  and  brevist  flexor 

' 


OSTEOLOGY.  5J 

Eublimis  digitorum,  flexor  longus  pollicis,  pronator  quadra* 
tus,  extensor  ossismetacarpi  pollicis,  extensor  primiinternodii 
pollicis,  pronator  radii  tergs.  [3.] 

CAB'PTO:  (8);  [i  after  birth]:  Scaphoi'dOB:  artic.  (5^ ; radius, 
trapezium,  trapezoid,  magnum,  semi-lunar.  Eex&i-lu&a'fO » 
artic,  (5) ;  radius,  magnum,  unciform,  scaphoid,  cuneiform. 
Cuneif&r'ffi*  •  artic,  (3);  semilunar,  pisiform,  unciform.  Pisifor'ma  5 
artic,  (i);  cuneiform.  Muse,  (2)  ; flexor  carpi  ulnarts,  abductor 
minimi  digiti,  (LowBR  ROW.)  Trape'iium  :  artic.  (4) ;  scaphoid, 
trapezoid,  ist  and  ad  metacarpal.  Muse.  (3) ;  abductor,  flexor 
ossis  metacarpi  and  flexor  brevis  pollicis.  TrapOZOi'doS :  artic. 
(4);  scaphoid,  ad  metacarpal,  trapezium,  magnum.  Muse. 
(i);  flexor  breTis  pollicis.  08  ttag'tUttl  artic,  (7);  scaphoid, 
semilunar,  ad,  3d,  4th  metacarpal,  trapezoid,  unciform. 
Jlfusc.  (i);  flexor  brevis  pollicis.  TJncifor'mo I  artic.  (5);  semi- 
lunar,  4th,  5th  metacarpal,  cuneiform,  os  magnum.  Muse,  (2)  ; 
flexor  brevis  and  flexor  ossis  metacarpi  minimi  digiti,  anterior 
annular  ligament. 

M2TACA2TU2  ;  (5);  bones  are  prismoid,  curved  longitudi- 
nally, convex  behind,  concave  in  front.  [2,  6th  week.]  Is:  \ 
artic.  (2);  trapezium,  ist  phalanx.  Muse.  (3);  flexor  and 
extensor  ossis  metacarpi  pollicis  t  xst  dorsal  interosseous.  21; 
Artie.  (5);  trapezium,  trapezoides,  magnum,  3d  metacarpus, 
ad  phalanx.  Muse.  (5);  flexor  carpi  radialis ,  extensor  carpi 
radialis  longior,  ist  and  ad  dorsal  interosseous,  ist  palmar 
interosseous.  3d!  artic,  (4);  magnum,  ad  and  4th  metacarpal, 
3d  phalanx.  Muse.  (5) ;  txtensor  carpi  radialis  brevior,  flexor 
brevis  pollicis,  adductor  pollicis,  ad  and  3d  dorsal  interosse- 
ous. 4th:  artic,  (5);  magnum,  unciform,  3d  and  5th  meta- 
carpal, 4th  phalanx.  Muse.  (3) ;  3d  and  4th  dorsal  and  ad 
palmar  interosseous.  5th  I  artic.  (3) ;  unciform,  4th  metacapal, 
5th  phalanx  Muse.  (5)  \flexor  and  extensor  carpi  ulnaris, 
flexor  ossis  metacarpi  minimi  digiti,  4th  dorsal  and  3d  palmar 
interosseous.  (An  error  in  "  Gray"  here.) 

PHALAN'GES :  (14) ;  [2,  6th  w.]  First  tow:  artic.  metacarpal 
and  zd  row.  Muse,  ist  or  thumb,  (4)  ;  extensor  primi  inter- 
nodiit  flexor  brevis,  abductor  and  adductor  pollicis.  Index, 
(2)  ;  tst  dorsal  and  palmar  interosseous.  Middle  finger,  (2)  ; 
3</and3^  dorsal  interosseous.  Ring  finger,  (2)  ;  4//4  dorsal 
and  ^d palmar  interosseous.  Little  finger,  (3)  ;  -^d palmar  in- 
terosseous, flexor  brevis  and  abductor  minimi  digiti.  Soconi 
tOWl  thumb,  (?}',  flexor  longus  and  extensor  secundi  internodii 
pollicis.  To  the  others,  (4) ;  flexor  sullimis  and  extensor 
communis  di^itorumt  with  extensor  indicts  to  index  an*\ 


54  OSTEOLOGY. 

extensor  minimi  digiti  to  little   finger.     Thill  WW  ;  flexor  pro- 
fundust  and  extensor  communis  digitorum. 

Xnnomina'tum I  crest,  superior,  middle  and  inferior  curved 
lines,  anterior  and  posterior  superior  and  inferior  spinal  pro- 
cesses, greater  and  lesser  sacro-sciatic  nothes,  ilio-pectineal 
eminence  line  and  grove,  acetabulum,  cotyloid  notch;  body, 
crest,  spine,  angle  of  pubes,  ischic  spine  and  tuberosity,  obtu- 
rator foramen,  ischic  and  pubic  rami ;  internal  iliac  fossa,groove 
for  obturator  and  pubic  vessels,  symphysis  pubis,  auricular 
and  sacro-iliac  rough  surfaces.  Artie.  (3);  fellow,  sacrum, 
femur.  Muse.  (33) ;  tensor  vaginee  femoris,  obliquus  externus 
and  internus,  latissimus  dorsi,  trans-versalis,  quadratus  lum- 
borum,  erector  spinae ;  3  glutaei,  rectus,  pyriformis,  iliacus, 
sartorius;  (ischium)  obturator  externus  and  internus,  levator 
ani,  2  gemelli,  coccygeus,  biceps,  semi-tendinosus,  semi-mem- 
branosus,  quadratus  femoris,  adductor  magnus,  transversus 
pcrinaei,  erector  penis;  (pubes)  Psoas  parvus,  pectincus, 
adductor  longus  and  brevis,  gracilis,  compressor  urethrse, 
(accelerator  urinae).  [8,  3  primary,  5  secondary.] 

Fe'nmr:  head,  depression  for  ligamentum  teres,ueck,greater 
and  lesser  trochanters,  spiral  line,  shaft,  internal  and  ex- 
ternal tuberosities  and  condyles  ;  digital  fossa,  trochanteric 
line,  inter-condyloid  notch,  linea  aspera.  Artie.  (3) ;  innomi- 
natum,  tibia,  patella.  Muse.  (23) ;  glutceus  medius  and  mini* 
mus,  pyriformis,  obturator  internus  and  externus ,  a  gemelli, 
quadratus  femoris  ;  psoas  magnus ,  iliacus  ;  2  vasti,  glut&us 
tnaximus,  biceps,  3  adductors,  pectinczus,  crureus  and  sub- 
crureus,  gastrocnemius,  plantaris,  popliteus.  [5,  5th  w.J 

Patelli:  subcutaneous  surface;  outer  and  inner  facets. 
Artie,  condyles  of  femur,  (ligamentum  patellae  attaches  it  to 
tibia.)  Muse.  (4);  rectus,  crureus,  vastus  externus  and  **»• 
ternus.  [Sesamoid,  3d  year.] 

TiVia:  head,  spine,  internal  and  external  tuberosity, 
tubercle,  fibular  facet,  crest,  internal  malleolus;  popliteal 
notch,  oblique  line,  nutrient  foramen,  common  groove  for 
flexor  longus  digitorum  and  tibialis  posticus,  another  for 
flexor  longus  pollicis.  Artie.  (3);  femur,  fibula,  astragalus, 
Muse.  (10);  semi-membranosus ;  tibialis  anticus,  extensor 
longus  digitorum;  sartorius,  gracilis,  semi-tendinosus ;  pop- 
liteus, soleus,  flexor  longus  digitorum,  tibialis  posticus,  liga- 
mentum patella.  [3,  sth  w.] 

Pit'nla:  head,  styloid  process,  shaft,  external  malleolus; 
groove  for  peroneus  longus  and  brevis,  nutrient  foramen. 
Artie  (2);  tibia,  astragalus.  Muse.  (9)  ;  biceps,  soleus,  3  pero- 


OSTEOLOGY.  55 

nei ;  extensor  longus  dlgitorum  and  pollicis,  tibialis  posticus, 
flexor  longus  poilicis.  [3,  6th  w.j 

TAB'SUS,  (7) :  Garcia  :  greater  and  lesser  processes,  tuber- 
cle, superior  and  inferior  grooves.  Artie.  (2)  ;  astragalus, 
cuboid.  Muse.  (8);  tibialis  posticus ,  tendo  Achillis,  plantarist 
abductor  pollicis  and  minimi  digiti,  flexor  and  extensor 
brevis  dlgitorum,  flexor  accessorius.  [i,  6th  m.]  Cuboi'des : 
artic.  (4);  calcis,  external  cuaeiform,  4th  and  5th  metatarsi 
(occasionally  scaphoid).  Muse,  (i)  ;  flexor  brevis  pollicis.  [x, 
9th  m.]  Astrag'alUB  J  artic.  (4);  tibia,  fibula,  calcis,  scaphoid. 
Muse.  none,  [i,  7th  m.]  Scaphoi'deS  I  artic.  (4)  ;  astragalus,  3 
cuneiform  (sometimes  cuboid.)  Muse,  (i)  j  tibialis  Posticus* 
[i,  4th  y.]  Cnaeifor'md  inter'iua:  largest  of  the  three;  artic. 
(4);  scaphoid,  middle  cuneiform,  ist  and  2d  metatarsal. 
Muse.  (2)  ;  tibialis  anticus  and  posticus.  [x,  3d  y.]  Cuieif01/£l0 
me'dius  :  smallest;  artic.  (4);  scaphoid,  internal  and  external 
cuneiform,  ad  metatars.  Muse.  none,  [i,  4th  y.)  Cuneifor'm* 
•xter'nug  :  artic.  (6);  scaphoid,  middle  cuneiform,  cuboid,  ad, 
3d,  4th  metatarsi.  Musc.(?)\  tibialis  posticus t  flexor  brevis 
pollicis.  [i,  ist  y.] 

METATAB'SUS,  (5):  shaft  straight,  posterior  extremity 
wedge-shaped,  anterior  rounded.  [2,  8th  w.]  Isi  :  greater 
size,  shortest.  Artie.  (3);  internal  cuneiform,  phalanx,  ad 
metatarsus.  Muse.  (3)  ;  tibialis  anticus,  peroneus  longus ,  xst 
dorsal  interosseous.  2i  I  longest.  Artie.  (6);  3  cuneiform, 
xst  and  3d  metatarsi,  2d  phalanx.  Muse.  (3);  adductor  pollicis, 
xst  and  26.  dorsal  interosseous.  3d:  artic.  (4);  external  cunei- 
form, ad  and  3d  metatarsus,  3d  phalanx.  Muse.  (4)  j  ad  and 
3d  dorsal  and  ist  plantar  interosseous,  adductor  pollicis.  itfc  \ 
artic.  (5);  external  cuneiform,  cuboid,  3d  and  sth  metatarsi, 
4th  phalanx.  Muse.  (4);  adductor  pollicis,  3d  and  4th  dorsal 
and  zd  plantar  interosseous.  5th  I  tubercular  eminence. 
Artic.  (3);  cuboid,  4th  metatarsus,  sth  phalanx,  Musc.($)\ 
pcroneus  brevis  and  tertzus,  flexor  brevis  minimi  digiti,  4th 
dorsal  and  3d  plantar  interosseous. 

PHALAN'GES,  (14):  shaft  convex  above,  concave  below; 
posterior  extremity  concave,  anterior  is  convex,  [a,  after  me- 
tatarsus.] l.t  iw:  artic.  metatarsal  and  ad  row.  Muse.:  big 
toe,  (5);  extensor  brevis  digitorum,transversus pedis, abductor t 
adductor  and.  flexor  brevis  pollicis.  Second,  (a);  u^anda*/ 
dorsal  interosseous.  Third,  (a) ;  3^  dorsal  and  ist  plantar 
interosseous.  Fourth,  (2);  tfh  dorsal  and  zd  plantar  interos- 
seous. Fifth,  {•$)**  flexor  brevis  and  adductor  minimi  digiti ', 
3^ plantar  inttrosseous.  21  TOV  .*  artic.  xst  and  3d  phalange*. 


56  ACTION   OF   MUSCLES. 

Muse,  big  toe,  (2)  ;  extensor  and  flexor  longus  follicis.  Re- 
maining toes,  (4  each)  ;  flexor  brev  is  digitourm,  and  ext.  longus 
and  brevis  digitorum,  lumbricalcs.  3d  TOWS  artic.  ad  phalan- 
ges. Muse.  (3  each)  ;  extensor  longus  and  brevis  ,  and  flexor 
longus  digitorunt. 

CSCIC'ULA  AUDITUS  (3):  Hal'  eus  :  head,  neck,  manubrium 
(handle),  processus  brevis  and  graci'is.  Artie,  (i);  incus. 
Muse.  (3);  laxator  major  and  minor  tymfani,  tensor  tymfani. 
Jn'cttS  I  body,  short  and  long  processes,  os  orbiculare.  Artie. 
(2);  malleus,  stapes.  Muse.  none.  Sta'pos  :  head,  neck,  base, 
crura.  Artie,  (i);  incus.  Muse,  (i);  stapedius. 


OF1  MUSCLES. 

Esad  is  moved  forwards  by  platysma  myoideus,  sterno- 
mastoid,  rectus  capitis  anticus  major,  rectus  capias  anticus 
minor,  (assisted  by,  when  jaw  is  fixed)  mylo-hyoid,  genio- 
hyoid,  genio-hyoglossus,  digastricus.  Backwards  by  trapc- 
*ius,  splenius  capitis,  complexus,  trachelo-mastoid,  rcct. 
Capt.  post,  maj.,  reel.  cap.  post,  min.,  obliquus  cap.  superior. 
Sideways  by  platysma  myoideus,  sterno-cleido-mastoid,  tra- 
pezius,  splenius  capitis,  splen.  colli,  trachelo-mastoid,  com- 
plexus. 

Neck:  forwards  by  platysma  myoideus,  sterno-cleido- 
mastoid,  digastricus,  mylo-hyoid,  genio-hyoid,  genio-hyo- 
glossus, omo-hyoid,  sterno-hyoid,  thyro-hyoid,  rect.  cap. 
ant.  major  and  minor,  longus  colli.  Backwards  by  trapezius, 
rhomboideus  minor,  serratus  posticus  superior,  splenius  capi- 
tis, splenius  colli,  complexus,  trachelo-mastoid,  transvcr- 
salis  colli,  inter-spinales  colli,  rect.  cap.  post.  maj.  and  minor, 
obliquus  capitis  superior  and  inferior,  scalenus  posticus, 
levator  anguli  scapulae.  Sideways  by  the  above  in  conjoined 
•ction,  and  the  scaleni,  inter-transversales,  recti-laterales. 

Trunk  !  forwards  by  rectus  abdominis,  pyramidalis,  obli- 
quus externus  and  internus  abdominis,  psoas  magnus  and 
parvus;  assisted  by  (when  arms  are  carried  forward^)  pecto- 
Talis  major  and  minor,  serratus  magnus.  Backwards,  trape- 
xius,  rhomboideus  major,  latissimus  dorsi,  serratus  posticus 
superior  and  inferior,  sacro-lumbalis,  longissimus  dorsi, 
spinales  dorsi,  semi-spinalis  dorsi,  multifidus  spinae,  inter" 
transversalis  dorsi  et  lumborum.  Laterally,  obliquus  exter- 
nus and  internus,  quadratus  lumborum,  longissimus  dorsi, 
sacro-lumbalis,  serratus  posticus,  latissimus  dorsi. 

favyti&l  forwards  by  pcctoralis  minor,  serratus  magnus, 
Backwards^  trapezius,  rhemboidei,  latissimus  dorsi.  U$- 


ACTION   OF   MUSCLES.  57 

wards,  trapezius,  levator  scapulae,  rhomboidei.     Downwards^ 
trapezius,  latissimus  dorsi,  pectoralis  minor. 

Easterns ;  forwards,  deltoid,  pectoralis  major;  assisted, 
sometimes,  by  biceps,  coraco-brachialis.  Backwards,  del- 
toid, tercs  major  and  minor,  triceps  (long  head),  latissimus 
dorsi.  Inwards,  pectoralis  major,  latissimus  dorsi.  Rotated 
inwards,  subscapularis,  assisted  by  pectoralis  major,  lat. 
dorsi,  teres  major.  JR.  outwards,  supra-spinatus,  iufra-spina- 
tus,  tercs  minor. 

Forearm:  forwards,  ticeps,  brachialis  anticus,  pronator 
radii  tercs;  assisted  by  flex,  carpi  rad.,  flex,  sublimis  digito- 
rum,  flex,  carpi  ulnaris,  supinator  longus.  Backwards,  tri- 
ceps, anconeus.  Rotated  inwards,  pronator  radii  teres,  flex, 
carpi  radialis,  palmaris  longus,  flexor  sublimis  dig.,  pronator 
quadratus.  R.  outwards,  biceps,  supinator  brevis,  extensor 
secuncli  internodii  pollicis. 

CarpttS:  forwards,  flex,  carpi  radialis,  palmaris  longus, 
flex,  sublimis  and  profundus  dig.,  flex,  carpi  ulnaris,  flex, 
longus  pollicis.  Backwards,  ext.  carpi  rad.  long,  and  brev. 
ext.  secundi  internodii  policis,  ext.  indicis,  ext.  com.  dig., 
ext.  prop,  pollicis.  Outuards,  flex,  carpi  rad.,  ext.  carp.  rad. 
long,  and  brevior,  ext.  ossis  metacarpi  pol.,  ext.  primi  inter- 
nodii pol.  Inwards,  flex,  sublim.  and  profund.  digitorum, 
flex,  and  ext.  carpi  ulnaris,  ext.  com.  dig.,  ext.  min.  digiti. 

Thumb :  iuwards  and  forwards,  opponens,  flex,  brevis 
and  flv.  x.  long,  pollicis.  Outwards  and  backwards,  ext.  ossis 
metacarpi,  ext.  primi  and  secundi  internodii  pollicis.  Up- 
wards and  away  from  fingers ,  abductor,  flex.  brev.  pollicis* 
Backwards  and  towards  fingers,  adductor,  ext.  primi  and 
secuntli  internodii  pollicis. 

TiagerS  \flexed,  flex,  sublimis  and  profundus  dig.,  lumbri- 
cales,  flex,  and  abductor  minimi  digiti.  Backwards,  ext.  com- 
munis,  ext.  minimi  digiti  and  indicis.  Outwards,  interossci, 
abductor  indicis  and  minimi  digiti.  Inwards,  interossei,  ab- 
ductor minimi  digiti. 

Thigh  \forwards,  psoas  mag.,  iliacus,  tensor  vaginae  fern, 
pectiacus,  adductor  longus  and  brcvis.  Backwards,  glut, 
max.  and  med.,  pyriformis,  obturator  intern.,  add.  mag., 
biceps,  semitend.,  semi-membranosus.  Inwards,  psoas  mag., 
iliacus,  pectineus,  gracilis,  the  3  adductores,  obturator 
extern.,  quad,  femoris.  Outwards,  tens.  vag.  fern.,  the  3 
glutaei,  pyriformis.  Rotated  inwards,  tens.  vag.  fern.,  glut, 
mcd.,  and,  if  leg  extended,  sartorius,  semi-tendinosus.  R. 
outwards,  glut.  max.  and  med.,  pyriformis,  gemelli,  obtura- 


5g  ACTIONS  OF   MUSCLES. 

tores,  quad,  fern.,  psoas  mag.,  iliacus,  the  3  adductores, 
biceps  femoris. 

I*6g  :  flexed,  semi-tendinosus,  biceps,  semi-membranosus, 
gracilis,  sartorius,  popliteus.  Extended,  rectusfem.,  crureus 
2  vasti. 

Pootl  inwards,  ext.  prop,  pollicis,  flex.  long,  dig.,  flex, 
long,  pol.,  tibialis  posticus.  Out-wards,  the  3  peronei,  ext. 
long.  dig.  Flexed,  tibialis  anticus,  ext.  prop,  pol.,  ext.  long, 
dig.,  peroneus  tertius.  Extended,  gastrocnemius,  plantaris, 
soleus,  flex.  long,  dig.,  flex,  long,  pol.,  tib.  posticus,  peroneus 
lopgus  and  brevis. 

Toes  :  flexed,  adductor,  abductor,  flex,  longus  and*  brevis 
pollicis,  abductor  and  flex.  brev.  minimi  digiti,  flex.  brev.  and 
longus  digitorum,  flex,  accessorius,  lumbricales,  interossei. 
Extended,  ext.  long,  and  brevis  digitorum,  ext.  prop,  pollicis. 
Inwards,  abductor  pollicis,  interossei.  Outwards,  add. 
pollicis  and  min.  digiti,  interossei. 


CIE-CTJL^TIO^ST. 

Cardiac  and  pulmoaic:  The  venae  cavae  receive  the  systemic 
venous  blood,  and  convey  it  into  the  right  auricle  ;  then  it 
passes  into  the  right  ventricle(  through  the  tricuspid,  or  auric- 
ulo-ventricular  valves,  to  be  thrown  into  the  pulmonic  artery 
(going  through  the  semilunar,  or  pulmonary  valves);  is  then 
conveyed  to  the  lungs  and  oxygenized  in  the  capillary  plexus 
about  the  intercellular  structure  and  the  air-cells,  and  re- 
turned, by  the  pulmonary  veins  (4  in  number)  to  the  left  side 
of  the  heart,  into  the  left  auricle  ;  it  then  passes  into  the  left 
ventricle  (through  the  mitral  valve)  to  be  forced  into  the 
aorta  (through  the  semilunar  valves),  and  from  thence  to  sup- 
ply the  system  at  large. 

Fetal  I  from  the  placenta  through  the  umbilical  vein  to 
to  the  liver;  from  thence,  by  the  hepatic  veins  and  ductux 
venosuf  Ar-antii,  to  the  inferior  vena  cava,.  to  the  right 
auricle  ;  the  most  of  the  current,  guided  by  the  Eustachian 
valve,  passes  through  the  foramen  ovale  into  the  /^/"/auricle, 
and  from  thence  into  the  left  ventricle,  and  from  thence  into 
the  aorta  and  system  at  large.  A  part  of  the  current,  how-, 
ever,  enters  the  right  ventricle,  is  then  forced  into  the  pul- 
monary artery,  and  from  the  imperviousness  of  thd  foetal 
lungs  is  most  all  conveyed  to  the  aorta  by  the  ductus  arterio- 
xus  Boialli.  The  blood  is  at  last  conducted  by  the  umbilical 
arteries  (branches  of  the  internal  iliac)  to  the  placenta  for 
reoxygenation. 


RESUME   OF    OSTEOLOGY.  59 

OSTEOH.O&Y. 


Number  of  Primary 

Name  of  Number  of  Muscles  Developmental 

Bone.  Articulations.  attached.  Cenires. 

Occipital 6 12 4 

Parietal ,'5 x x 

Frontal 12 3 a 

Temporal 5 14 4 

Sphenoid 12 12 10 

Ethmoid 15 none 3 

Nasal 4 none x 

Maxillary  Sup 9 9 4 

Lachrymal 4 i x 

Malar 4 5 x 

Palate 7 4 x 

Turbinated  Inf 4 none x 

Vomer 6 none 9 

Maxillary  Inf ......  2 14 2 

Hyoid none n 5 

Sternum , 16 10 6 

Ribs  (12) 24 19 34 

Clavicle 3 6 a 

Scapula 2 17... 7 

Humerus 3 24 7 

Ulna 2 13 3 

Radius 4 9 3 

Scaphoid 5 none x 

Semilunar 5 none x 

Cuneiform 3 none i 

Pisiform i 2 x 

Trapezium 4 3 x 

Trapezoid 4 x x 

Os  Magnum 7 i •...  x 

Unciform 5 2 x 

Metacarpal(s) 19 18 10 

Phalanges  (14) 23 20 28 

Vertebrae  (24) 72 39 85 

Sacrum 4 5 n 

Coccyx i 4 4 

Innominatum 3 33 3  aud  5 

Femur 3 23 5 

Patella x 4 sesamoid 

Tibia 3 10 3 


6o 


INDEX. 


Fibula 2 9 3 

Calcis a 8 X 

Cuboid 4 i i 

Astragalus 4 none x 

Scaphoid 4 i I 

Int.  Cuneiform 4 2 I 

Mid.  Cuneiform 4 none i 

Ext.  Cuneiform 6 2 x 

Mctatarsal  (5) 21 13 10 

Phalanges  (14) ...23 23 28 

Malleus i 3 ? 

Incus 2 none t 

Stapes x i ? 

I  IN"  I>  E  X . 

PAGE. 

Arteries  :  Body 29 

Extremity  (lower) 39 

"  (upper) 19 

Head  and  Neck 6 

Body 06 

Circulation 58 

Extremity  (lower) „  35 

"        (  upper) x6 

Head  and  Neck x 

Muscles:  Action  of 56 

Boc'y 26 

Extremity  (lower) 35 

(upper) 16 

Head  and  Neck x 

Nerves  :  Body 35 

.Extremity  (lower) 44 

(upper) 23 

Head  and  Neck 13 

Osteology 48 

Resume  Table  of 59 

Veins:  Body 33 

Extremity  (lower) 43 

"  (upper) 29 

Head  and  Neck _  x* 


The  Vest-Pocket  Anatomist, 

BY  C.  HENRI  LEONARD,  A.  M.,  M.  D., 

Third  Edition  (8th  Thousand)— Paper,  50c,  Cloth, 
75c.  Used  in  every  Mediral  College  in  the  Unit- 
ed States.  1,500  copies  ordered  by  Balliere,  Tyn- 
dall  &  Cox,  London,  England. 

CONTENTS  : 

Each  BONE:  its  name;  pronunciation;  the  points  of  in- 
terest; the  number  and  names  of  muscles  attached 
(those  oC  insertion  being  indicated  by  different  type); 
number  of  articulations,  and  names  of  bones  articu- 
lating; number  of  developmental  centers,  and  time 
of  <arst  appearance.  f 

Each  MUSCLE:  its  name;  origin;  insertion;  nervous  tup- 
bly;  pronunciation;  etc. 

Each  ARTERY:  its  name;  number  of  branches  from  main 
ves&el;  pronunciation  of  each;  origin;  course;  struc- 
tures supplied ;  anastomosis.  (Given  in  successive 
order  of  origin ;  the  main  vessels  indicated  by  larger 
type.) 

Each  VEIN:  its  name;  pronunciation;  course;  where 
emptying;  vessels  received;  number  of  valves,  etc. 

Each  .VERVE-  its  name;  pronunciation;  origin;  course; 
branches;  distribution;  anastomosis,  etc.  (Main 
branches  indicated  by  larger  type.) 

Complete  resume  TABLE  of  the  bones. 

CLASSIFIED  TABLE  of  the  action  of  the  muscles. 


THE  CODES  OF  MEDICAL  ETHICS. 

Paper,  25  cents. 

CONTENTS;  The  Code  of  Ethica  of  the  American  M^di- 
cal  Association;  tnat  oi'  the  American  Institute  of 
Homoeopathy;  that  of  the  National  Eclectic  Medi- 
cal Society. 


her  book  aent  post-paid  upon  receipt  of  price  by 
the  publisher, 

C.  Henri  Leonard,  M.  D., 

DETROIT,  MICH. 


A  New  Yaginal  Speculum. 

BY  C.  HENRI  LEONARD,  M.  D. 


The  cut  gives  a  view  of  the  speculum  when  folly 
expanded.  As  now  seen,  the  tips  of  the  blades  are  4^ 
inches  apart;  the  inside  measurement  of  the  base  of  the 
blades  being  2%  inches.  By  the  thumb  screw  attached  to 
the  lower  blade,  it  (the  lower  blade)  may  be  fixed  at  any 
point  upon  the  perineal  rods.  When  the  base-extension, 
by  the  means  of  the  perineal  rods,  is  not  made  use  of,  the 
opening  is  then  the  same  size  as  in  the  ordinary  bivalve 


specula.  When  thus  closed,  and  the  superior  blade  is 
not  elev&ted,  the  speculum  is  in  form  ready  for  intro- 
duction. The  upper  blade  is  ^  inch  shorter  than  the 
lower  one,  thu8  allowing  an  expansion  of  the  blades 
without  the  rubbing  of  the  upper  one  over  an  inflamed 
cervix  uteri.  The  blades  measure,  from  the  attachments 
of  the  perineal  rods,  respectively  4%  and  6  inches  in 
length.  The  upper  blade  ha*  a  fenestra  which  admits  the 
urethra,  thus  relieving  all  pressure  upon  this  sensitive 
oreran  when  the  perinseum  is  fully  depressed  The 
lower  blade  also  has  a  fenestra  extending  from  its  base  to 
within  an  inch  of  its  tip ;  this  allows  an  easy  probing  o  f 
an  anteflexed  uterus,  bent  to  an  acute  angle,  the  probe 
being  allowed  to  press  down  the  posterior  vaginal  wall, 
through  this  opening,  until  it  can  easily  enter  and  traverse 
the  distorted  cervical  canal.  £V 

The  blades  are  well  rounded  up,  and  so-  relieve  an 
excessive  stretching  of  the  vagina  at  their  side?,  thus 
making  the  instrument  of  easy  introduction  and  painless 
to  the  patient.  Indeed,  every  patient  that  1  have  used  one 
upon  (and  I  have  used  them  in  many  cases,  and  in  vaginse 
of  all  sizes,  parties  married  and  unmarried)  has,  upon 
questioning  her  in  regard  to  the  matter,  declared  that  it 
gave  her  the  least  discomfort  of  any  she  had  had  introduced}. 

You  can  make  any  operation  upon  the  uterus  or  the 
sides  of  the  vagina  with  this  instrument ;  and  by  its  use 
you  may  dispense  with  an  assistant.  When  the  perineal 
rods  are  used  it  is  essentially  a  Sim's  Speculum,  enly 
a  self-retaining  one.  It  may  be  used  with  the  patient  c-n 
the  back,  or  in  the  u  Sim's  position  ",  at  the  option  of  the 
operator. 

Each  instrument  is  made  in  the  highest  style  of  the 
art  possible,  and  is  finished,  in  fall,  in  heavy  nickel- 
plate,  and  mil  be  warranted  perfect  in  its  action, 

Sent  post  or  express-paid  on  receipt  of  the  price  by 

C.  HENRI  LEONARD,  M.  D., 

DETROIT,  MICH. 


LEONARD'S  DOSE  AND  DAY  BOOK 

Leather,  with  Pencil  Loop— $1.25. 

Printed  matter  is  the  same  as  in  REFERENCE  and 
DOSE  BOOK.  To  this  has  been  added  an  uniquely  designed 
Daily  Record  for  charges  and  patients  to  be  visited,  so 
r.rranged  as  to  be  posted  to  any  Ledger  at  the  end  of  eack 
month.  It  has  a  capacity  for  6,000  entrances  of  Debits, 
ftnd  like  number  of  Credits  (or  for  15  patients  a  week) :  a 
complete  Obstetric  Record  for  64  cases  ;  16  pages  for  Mis- 
cellaneous Accounts  and  16  pages  for  Memoranda. 

It  is  by  far  the  cheapest,  most  condensed  and  com- 
prehensive Day-Book  or  Record  yet  devised.  Accounts 
can  be  kept  '.a  one-fifth  the  usual  time,  and  with  no  writ- 
ing but  (he  name  and  address  of  the  patient,  and  th* 
figures  indicating  the  charges.  Is  good  for  one  year  from 
the  first  of  any  month.  Short  accounts  need  no  Ledger 
posting. 

LSONASD'S  MULTUM  IN  FABVO  LEDGES. 
Post-paid— $2.50. 

This  is  designed  especially  for  the  Dose  and  Day- 
Book,  and  greatly  facilitates  "posting."  It  does  away 
with  all  the  paging  and  much  of  the  figuring  required  in 
the  regular  Ledger  system.  On  a  single  line  of  a  pag* 
the  entire  debit  and  credit  account  of  a  patient,  ia 
monthly  statements,  is  seen  for  the  entire  year.  It  it 
divided  into  five  portions,  and  will  accommodate  401* 
patients  yearly  for  five  years. 

By  the  use  of  these  Books  nine-tenths  of  the  labor  of 
book-keeping  is  done  away  with.  Though  the  Ledger  can 
be  used  only  with  the  Dose  and  Day  Book,  yet  the  latter 
can  be  used  with  any  Ledger. 

Either  post-paid  on  receipt  of  price. 

C.  HENRI  LEONARD,  M.  D. 

DETROIT.  Mica. 


DISEASES  AND  TREATMENT. 

By  C,  HENRI  LEONARD,  A,  M.,  M.  D, 
Cloth,  Post-paid,  $1.25. 

ILLUSTRATED    BY  NUMEROUS  ENGRAVINGS    OF 

THE  MICROSCOPICAL  APPEARANCE  IN 

HEALTH  AND   DISEASE. 


Cl 


CONTENTS: 


iiapters  upon  the  Physiology  of  the  Shaft  and  Bulb. 
The  Chemistry  of  the  Hair. 

The  Microscopy  of  the  Hair  and  Bulb. 
Hirsuties,  or  excess  of  Hair. 
Alopecia,  or  Baldness. 

Canities,  or  Blanching  of  Hair. 
Asteatodes. 

Pityriasis,  or  Dandruff. 
Seborrhoea. 
Eczema. 

Tinea  Favosa. 

Tinea  Tonsurans  and  Kerion. 
Tinea  Alopecia. 

Tinea  Sycosis  (mentagra). 
Acne  and  Impetigo. 

Vegetable  Parasitic  Diseases  in  General. 
Animal  Parasites. 
Phthiriasis,  or  Louse  Disease. 
Acarus  Folliculorum, 
Diseases  of  the  Color  of  the  Hair. 
Chignon  Fungus. 
Coloring  the  Hair. 
Dressing  the  Hair. 

Removing  Superflous  Hairs. 

Description  of  Hair  Shafts  of  Ancient  Egyptians,  Peru- 
vian Incas,  the  Babylonians,  and  Uses  made  of  the  Hair, 
and  Miscellaneous  Anecdotes.  IN  PRESS. 


C.  HENRI  LEONARD,  M.  D.,  PUBLISHER, 

Detroit,  Mich. 


X.  SONAR  13*8 

Prescription   Blanks   and   Tablet 

THE  CHEAPEST  BLANKS  PUBLISHED. 

Each  Tablet  is  made  up  of  neatly  printed  Blanks,  and  is  stoutly  bound, 
and  has  a  good,  stiff  pasteboard  back  ;  on  the  back  of  the  Tablet  (not  the 
Blanks),  is  given  the  Antidotes  to  Poisons,  and  Eules  for  Genitive  Case- 
endings  in  Prescription-Writing. 

Each  Blank  has  printed  on   its  face  the  Name,  Address  and  Office  Hours 
of  the  Physician;  the  Name,  Address,  ete.,  of  the  Druggist  ;  also  t'ae  sign 
of  Eecipe  in  its  appropriate  position.    The  size  of  each  blank  is  3J<j  I 
inches,  or  3,4  by  s}4  inches,  (according  to  style  preferred),  and   all   are 
cut  from  the  best  60-pound  book  paper. 

PRICES. 
For  6,000  Blanks  done  up  into  150  Tablets,  with 

12  changes  in  Physicians'  addresses $15.00 

For  0,000  Blanks,  done  up  into  60  Tablets,  12 

changes  in  the  Physicians'  addres  es $12.00 

For  6,000  Blanks,  done  up  into  60  Tablets,  with 

6  changes  in  the  Physi  -ians'  addresses $10.00 

For  4,000  Blanks,  done  up  into  40  Tablets,  with 

8  changes  in  the  Physicians'  addresses $  8.00 

For  :!.000  Blanks,  done  up  into  30  Tablets,  with 

6  changes  in  the  Physicians'  addresses $  6.50 

For  2,000  Blanks,  done  up  into  20  Tablets,  with 

4  changes  in  the  Physicians'  addresses $  4.50 

For  1,000  Blanks,  done  up  into  10  Tablets,  with 

2  changes  in  the  Physicians' addresses $  2.50 

Be  sure  and  write  THE  ADDRESSES  plainly  or  send  cards 
when  possible. 

METRIC    BLANKS. 

These  are  same  size  and  prices  as  the  ordinary  Blanks 
described  above,  but  are  furnished,  in  addition  to  Physi- 
cians1 and  Druggists'  name  and  addresses,  with  Metric 
lines  for  the  Gramme  and  Centigramme.  The  back  of 
the  Tablets  bear,  instead  of  Antidotes  to  Poisons,  etc., 
Ready  Rules  to  and  from,  Metric  Weights,  Exceptions  and 
Sp.  Gr.  of  Exceptions,  and  table  of  Exact  Values  of  ordinary 
weights  or  measures  in  Metric  system.  Sample  Blanks  on 
receipt  of  stamps.  No  goods  sent  except  on  receipt  of  the 
full  amount  in  advance.  We  will  stand  all  errors  made  in 
"following  copy." 

When  ordered  sent  by  mail  25  cts  for  each  1,000  must  be 
added  to  the  above  prices  for  postage. 

Address  all  orders  to 

C.  HENRI  LEONARD,  M.D.,  DETROIT,  Mien. 


THE  HIPPOCRATIC  OATH, 

LAW  AND  APHORISMS. 

EDITED  BY  C.  HENRI  LEONARD.  A.  M.,  M.  I). 
Octavo,  paper  covers,  post-paid  $1.00. 

In  this  edition  the  several  translations  and  annotations 
will  bo  diligently  compared,  and  as  free  a  rendering  as 
possible  of  the  Greek  idioms  will  be  given.  A  smooth  ver- 
sion, rather  than  a  strictly  literal  one,  will  be  the  object  of 
the  editor.  There  has  been  no  recent  edition  of  the  work 
of  this  author,  the  Father  of  Medicine,  issued,  and  none 
in  a  popular  edition  from  the  American  press.  No  physi- 
cian should  remain  ignorant  of  the  sound  medical  teachings 
found  in  these  Aphorisms.  IN  PREPARATION. 


TIHIIE 


By  Dr.  CARL  MICHEL,  of  Cologne. 
Translated  from  the  German  by  Professors  C,  YOUNG 

and  C,  C,  YEMANS,  M,  D, 
OCTAVO,  112  PAGES,  PAPER  COVERS,  POST-PAID, 


Any  one  having  anything  to  do  with  nasal  and  phar- 
yngeal  diseases,  the  scourge  of  our  north-temperate 
climates,  can  illy  afford  to  be  without  this  great  specialist's 
monograph.  Its  low  price  places  it  in  easy  reach  of  all. 

C.  HENRI  LEONARD,  M,  D.,  PUBLISHER, 

S.  E.  Cor.  Gratiot  and  Woodward  Aves.,  DETROIT,  Mien. 


The  Medical  Advance. 


PEEMIUMS  AND  CLUBBING  BATES. 


For  FIVE  DOLLARS,  I  will  send  five  dollars'  worth  of  the 
Pharmaceutical  Preparations  advertised  in  this,  journal  by  F. 
Stearns — (Fluid  extracts,  new  products,  sugar-coated  pills,  elixirs, 
resinoides,  lozenges,  suppositories,  syrups,  tinctures,  etc.,  etc.)  at  his 
best  prices,  and  include  a  copy  of  th«  MEDICAL  ADVANCE  free 
for  one  year. 

For  FOUR  DOLLARS,  I  will  send  four  dollars'  worth  surgical 
instruments  or  apparatus  of  any  sort,  or  from  any  list,  at  best  prices 
and  include  a  copy  of  the  MEDICAL  ADVANCE  for  one  year. 

For  THREE  DOLLARS,  I  will  send  three  dollars'  worth  of 
any  medical  books,  and  a  copy  of  the  MEDICAL  ADVANCE  free 
for  one  year. 

For  TWO  DOLLARS,  I  will  send  two  dollars'  worth  of  any 
of  my  publications,  postpaid,  and  a  copy  of  the  MEDICAL  ADVANCE 
free  for  one  year. 

For  ONE  DOLLAR  AND  A  HALF,  I  will  send  i  copy  of 
Leonard's  Day-book,  with  your  name,  town  and  State  on  the  side 
in  gold-leaf,  and  a  copy  of  the  MEDICAL  ADVANCE  for  one  year 
free. 

For  the  regular  SUBSCRIPTION  PRICE  of  any  regular  two- 
dollar  (or  one)  medical  journal  published  in  the  United  States,  I 
will  send  a  copy  of  such  journal,  and  include  a  copy  of  the  MEDI- 
CAL ADVANCE  for  one  year  free. 

For  TWO  DOLLARS  AND   FIFTY  CENTS,  I  will  send  a 

food  Hypodermic  Syringe  (retail  price  two  dollars  and  fifty  cents), 
y  ma.\\,  Postpaid,  and  include  a  copy  of  the  MEDICAL  ADVANCE 
for  one  year  free. 

For  TWO  DOLLARS  AND  FIFTY  CENTS,  I  will  send  by 
•n\3i\\,  Postpaid,  a  good  4-inch  clinical,  or  fever  thermometer — self- 
registering  scale — in  hard  rubber  case,  and  include  a  copy  of  the 
MEDICAL  ADVANCE  one  year  free. 

For  TWO  DOLLARS,  I  will  send  any  pattern  pocket  medicine 
case,  the  regular  price  of  which  is  two  dollars,  and  include  the 
MEDICAL  ADVANCE  for  one  year. 

C,  HENRI  LEONARD,  A.M..M.  D,, 

Editor  and  Publisher. 


524777 
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